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埃塞俄比亚西南部吉马市吉马大学医学中心成年白内障手术患者的视觉结果及相关因素

Cataract Surgery Visual Outcome and Associated Factors Among Adults Attended Jimma University Medical Center, Jimma, Southwest Ethiopia.

作者信息

Mohammed Jemmal, Assegid Sahilu, Fekadu Lata, Kabeta Teshome

机构信息

Department of Ophthalmology, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Ethiopia.

Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.

出版信息

Clin Ophthalmol. 2023 Nov 3;17:3341-3351. doi: 10.2147/OPTH.S434453. eCollection 2023.

Abstract

BACKGROUND

Cataract is the leading cause of blindness and the second leading cause of visual impairment worldwide, accounting for 51% and 33% of all cases, respectively, in low- and medium-income countries bearing a disproportionately high burden. Hence, this study aimed to assess the visual outcome of age-related cataract surgery and identify factors associated with patients' postoperative visual outcomes in Jimma University Medical Center, Southwest Ethiopia.

METHODS

An institution-based cross-sectional study design was conducted among 386 cataract surgery patients from January 1, 2016, to December 30, 2017. The study participants were selected using a systematic random sampling technique. Data were collected by reviewing the selected patients' medical records using a pre-tested checklist, entered into EpiData version 3.1, and exported to SPSS 20 for analysis. Proportions, summary statistics, and tables were used for presentations of the findings. Binary logistic regression was carried out to identify independent predictors of visual outcome. Findings were presented with adjusted odds ratios and their 95% confidence interval. A p-value <0.05 was used to declare a statistically significant association.

RESULTS

About 231 individuals (59.8%) had poor visual results following cataract surgery. Furthermore, age >70 (AOR = 3.64; 95% CI [1.35-9.82]), preoperative ocular co-morbidities (AOR = 2.34; [1.32-4.15]), incision-based cataract surgery (AOR = 7.11; [3.16-16.02]), compared phacoemulsification operated by resident surgeons (AOR = 2.19; [1.23-3.89]), presence of intraoperative complication (AOR = 3.41; [1.47-7.92]), lens remnant (AOR = 2.91; [1.11-4.92]), ocular inflammation (OR = 2.56; [1.34-4.92]), and striate keratopathy/corneal edema (AOR = 1.91; [1.07-3.44]) were significantly associated with poor visual outcome.

CONCLUSION

The visual outcome following cataract surgery fall below WHO recommendation. In this study, age, ocular co-morbidities, surgical method, surgeon status, intraoperative complication, SK, and ocular inflammation associated with post-operative Uveitis and anterior chamber reaction were associated with a poor visual outcome.

摘要

背景

白内障是全球失明的主要原因和视力损害的第二大原因,在低收入和中等收入国家分别占所有病例的51%和33%,负担 disproportionately 高。因此,本研究旨在评估埃塞俄比亚西南部吉马大学医学中心年龄相关性白内障手术的视觉结果,并确定与患者术后视觉结果相关的因素。

方法

2016年1月1日至2017年12月30日期间,对386例白内障手术患者进行了一项基于机构的横断面研究设计。研究参与者采用系统随机抽样技术选取。通过使用预先测试的检查表审查选定患者的病历收集数据,输入EpiData 3.1版本,并导出到SPSS 20进行分析。比例、汇总统计和表格用于呈现研究结果。进行二元逻辑回归以确定视觉结果的独立预测因素。研究结果以调整后的优势比及其95%置信区间呈现。p值<0.05用于宣布具有统计学意义的关联。

结果

约231人(59.8%)白内障手术后视力结果不佳。此外,年龄>70岁(AOR = 3.64;95% CI [1.35 - 9.82])、术前眼部合并症(AOR = 2.34;[1.32 - 4.15])、基于切口的白内障手术(AOR = 7.11;[3.16 - 16.02])、与住院医师进行的超声乳化术相比(AOR = 2.19;[1.23 - 3.89])、术中并发症的存在(AOR = 3.41;[1.47 - 7.92])、晶状体残留(AOR = 2.91;[1.11 - 4.92])、眼部炎症(OR = 2.56;[1.34 - 4.92])以及条纹状角膜病变/角膜水肿(AOR = 1.91;[1.07 - 3.44])与视力不佳显著相关。

结论

白内障手术后的视觉结果低于世界卫生组织的建议。在本研究中,年龄、眼部合并症、手术方法、外科医生状态、术中并发症、SK以及与术后葡萄膜炎和前房反应相关的眼部炎症与视力不佳相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf97/10629348/cb3c39eff279/OPTH-17-3341-g0001.jpg

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