Ali Muhammad, Dun Chen, Chang David F, Son Hyeck-Soo, Woreta Fasika A, Soiberman Uri S, Prescott Christina R, Makary Martin A, Srikumaran Divya
From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland (Ali, Son, Woreta, Soiberman, Srikumaran); Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dun, Makary); Department of Biomedical Informatics and Data Science, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dun); Altos Eye Physicians, Los Altos, California (Chang); Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany (Son); Department of Ophthalmology, NYU Grossman School of Medicine, New York, New York (Prescott).
J Cataract Refract Surg. 2025 Mar 1;51(3):210-217. doi: 10.1097/j.jcrs.0000000000001597.
To assess 5-year trends in the rate of immediate sequential bilateral cataract surgery (ISBCS) and surgeon characteristics associated with performing ISBCS.
100% Medicare Fee-For-Service beneficiaries from 2018 to 2022.
Cross-sectional study.
ISBCS cases were identified among patients aged 65 years or older undergoing bilaterally performed cataract surgery (BPCS). Cochrane Armitage trend test was used to assess patient and surgeon characteristics over time. Multivariate logistic regression was used to evaluate surgeon characteristics associated with performing ISBCS.
Among 1 190 169 BPCS, 3954 (0.33%) were ISBCS. Quarterly ISBCS rate increased from 2.12 to 5.5 per 1000 BPCS ( P < .001). Among 10 290 surgeons, 1119 (10.87%) performed ISBCS on some patients. Proportion of surgeons performing ISBCS per 1000 cataract surgeons increased from 15.63 during the first quarter of 2018 to 26.55 during the last quarter of 2022 ( P < .001). Among the ISBCS surgeons, the proportion of ISBCS cases per 1000 BPCS doubled from 17.20 in 2018 to 35.50 in 2022 ( P < .001). On multivariate analysis, surgeons in the highest surgical volume quartile (odds ratio [OR], 1.21; 95% CI, 1.01-1.45; Ref: lowest quartile), recent graduates (0 to 10 years: OR, 2.43; 95% CI, 1.87-3.15; Ref: ≥ 31 years), and surgeons in the West (OR, 2.408; 95% CI, 2.052-2.826; Ref: South) had higher odds of performing ISBCS.
There was an increased rate of ISBCS possibly suggesting greater interest among patients and surgeons. Although the overall ISBCS rate remained low, the number of surgeons performing ISBCS increased. Higher volume surgeons, recent graduates, and those practicing in the West were more likely to perform ISBCS.
评估即时序贯双侧白内障手术（ISBCS）的发生率及与开展该手术相关的外科医生特征的5年趋势。
2018年至2022年100%的医疗保险按服务付费受益人。
横断面研究。
在65岁及以上接受双侧白内障手术（BPCS）的患者中识别出ISBCS病例。采用Cochrane-Armitage趋势检验评估患者和外科医生特征随时间的变化。多因素逻辑回归用于评估与开展ISBCS相关的外科医生特征。
在1190169例BPCS中，3954例（0.33%）为ISBCS。ISBCS的季度发生率从每1000例BPCS中的2.12例增加到5.5例（P <.001）。在10290名外科医生中，1119名（10.87%）对部分患者实施了ISBCS。每1000名白内障外科医生中开展ISBCS的比例从2018年第一季度的15.63%增加到2022年最后一个季度的26.55%（P <.001）。在实施ISBCS的外科医生中，每1000例BPCS中ISBCS病例的比例从2018年的17.20%翻倍至2022年的35.50%（P <.001）。多因素分析显示，手术量最高四分位数的外科医生（比值比[OR]，1.21；95%置信区间[CI]，1.01 - 1.45；对照：最低四分位数）、近期毕业生（0至10年：OR，2.43；95% CI，1.87 - 3.15；对照：≥31年）以及西部的外科医生（OR，2.408；95% CI，2.052 - 2.826；对照：南部）开展ISBCS的可能性更高。
ISBCS的发生率有所增加，这可能表明患者和外科医生的兴趣更高。尽管ISBCS的总体发生率仍然较低，但开展该手术的外科医生数量有所增加。手术量较高的外科医生、近期毕业生以及在西部执业的医生更有可能开展ISBCS。
