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美国白内障手术与国际外展活动的成本效用、视力及人文结局比较

Comparison of Cost-Utility, Visual Acuity, and Humanistic Outcomes of Cataract Surgery Performed in the United States Versus International Outreach Campaigns.

作者信息

Chen Lauren E, Vahidi Ryka, Kesler-Diaz Anna, Mosaed Sameh

机构信息

Department of Ophthalmology, Gavin Herbert Eye Institute, University of California Irvine, Irvine, CA 92617, USA.

University of California Los Angeles, Emergency Medical Services, Los Angeles, CA 90095, USA.

出版信息

J Clin Med. 2025 Apr 28;14(9):3037. doi: 10.3390/jcm14093037.

DOI:10.3390/jcm14093037
PMID:40364069
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12072738/
Abstract

This study compares the cost-utility, visual acuity, and humanistic outcomes of phacoemulsification surgery performed during international outreach campaigns to outcomes in the U.S. : Humanitarian organizations frequently perform cataract surgeries in underserved regions, yet the outcomes of phacoemulsification in these settings remain unexplored. This study aims to compare the visual acuity outcomes, quality-of-life outcomes, and cost of phacoemulsification surgery during international outreach campaigns with those in the U.S. : This retrospective review analyzed 344 cases from Women for World Health (W4WH) missions and 305 consecutive cases from the academic practice of the lead surgeon of W4WH in the US. The pre-operative (pre-op) visual acuity, post-operative (post-op) visual acuity at day 1, and best-corrected visual acuity (BCVA) at post-op month 1 were compared to baseline. The change in visual acuity was compared between the two groups. Complication rates, cost per case, and quality-of-life measures were evaluated for the mission group compared to cataract surgery outcomes in the developed world. : The mission cohort had worse baseline visual acuity than the U.S. cohort (1.36 logMAR vs. 0.50 logMAR, < 0.0001) and showed greater mean improvement (1.24 logMAR vs. 0.35 logMAR, < 0.0001). Both cohorts achieved similar BCVA at post-op month 1 (0.13 logMAR). The cost for the mission group was USD 276 per surgery. A total of 93.94% of patients in the mission group achieved a BCVA of 20/40 or better, which is comparable to the U.S. outcomes. : The dramatic impact, immediacy, and enduring effect of cataract surgery using phacoemusification on quality of life, mental health, and economic return on investment make it the ideal procedure for humanitarian settings. Considering all of the available metrics, our data support the continued expansion of humanitarian efforts by cataract surgery organizations worldwide.

摘要

本研究比较了国际外展活动中进行的白内障超声乳化手术与美国白内障超声乳化手术的成本效益、视力及人文结局:人道主义组织经常在服务欠缺地区开展白内障手术,但这些地区白内障超声乳化手术的结局仍未得到探索。本研究旨在比较国际外展活动中白内障超声乳化手术与美国白内障超声乳化手术的视力结局、生活质量结局及成本:这项回顾性研究分析了“世界卫生女性组织”(W4WH)任务中的344例病例以及W4WH美国首席外科医生学术实践中的305例连续病例。将术前视力、术后第1天的视力以及术后第1个月的最佳矫正视力(BCVA)与基线进行比较。比较两组之间的视力变化。与发达国家白内障手术结局相比,评估了任务组的并发症发生率、每例成本及生活质量指标:任务组队列的基线视力比美国队列差(1.36对数最小分辨角对数单位对0.50对数最小分辨角对数单位,P<0.0001),且平均改善幅度更大(1.24对数最小分辨角对数单位对0.35对数最小分辨角对数单位,P<0.0001)。两组在术后第1个月时的BCVA相似(0.13对数最小分辨角对数单位)。任务组每次手术的成本为276美元。任务组中共有93.94%的患者BCVA达到20/40或更好,这与美国的结局相当:使用超声乳化技术进行的白内障手术对生活质量、心理健康及投资经济回报具有显著影响、即时效应及持久作用,使其成为人道主义环境中的理想手术。综合所有可用指标,我们的数据支持全球白内障手术组织继续扩大人道主义努力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a46/12072738/2fc4f0e5e386/jcm-14-03037-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a46/12072738/8c4481662c05/jcm-14-03037-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a46/12072738/2fc4f0e5e386/jcm-14-03037-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a46/12072738/8c4481662c05/jcm-14-03037-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a46/12072738/2fc4f0e5e386/jcm-14-03037-g002.jpg

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本文引用的文献

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Implementation of SICS (small incision cataract surgery) in humanitarian campaigns: Description of the surgical technique and review of the literature.小切口白内障手术(SICS)在人道主义行动中的应用:手术技术描述及文献综述
Arch Soc Esp Oftalmol (Engl Ed). 2025 Feb;100(2):91-97. doi: 10.1016/j.oftale.2024.12.014. Epub 2024 Dec 26.
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Global prevalence of cataract surgery.白内障手术的全球患病率。
Curr Opin Ophthalmol. 2025 Jan 1;36(1):10-17. doi: 10.1097/ICU.0000000000001092. Epub 2024 Sep 25.
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The association between cataract surgery and mental health in older adults: a review.
白内障手术与老年人心理健康的关联:综述
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Cataract and systemic disease: A review.白内障与全身系统性疾病:综述
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