Klein B E, Klein R, Moss S E
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison.
Am J Ophthalmol. 1995 Mar;119(3):295-300. doi: 10.1016/s0002-9394(14)71170-5.
We studied the incidence of cataract extraction in people with diabetes of long duration to determine which factors are associated with higher risk of surgery.
We recruited a probability sample of all persons receiving care for diabetes in an 11-county area of southern Wisconsin for a prevalence study of diabetic retinopathy. All 2,366 subjects were examined between September 1980 and June 1982. During the slit-lamp examinations, presence of the lens, whether natural or prosthetic, was noted. The subjects were reexamined four and ten years after the initial prevalence study. Occurrence of cataract extraction in the interim between examinations was recorded.
In the younger-onset group there was an 8.3% (95% confidence interval, 6.2%, 10.8%) cumulative incidence, and in the older-onset group there was a 24.9% (95% confidence interval, 21.3%, 28.5%) cumulative incidence of cataract surgery in the ten-year interval. Characteristics statistically significantly related to cataract surgery in the younger-onset group in multivariate analysis were age, severity of diabetic retinopathy, and proteinuria. In the older-onset group, age and use of insulin were associated with increased risk.
These data indicate that cataract surgery is a relatively frequent occurrence in people with diabetes. This finding needs to be considered to plan for health care for people with diabetes.
我们研究了长期糖尿病患者白内障摘除术的发生率,以确定哪些因素与较高的手术风险相关。
我们选取了威斯康星州南部11个县接受糖尿病治疗的所有患者的概率样本,用于糖尿病视网膜病变的患病率研究。所有2366名受试者在1980年9月至1982年6月期间接受了检查。在裂隙灯检查期间,记录晶状体的存在情况,无论是天然晶状体还是人工晶状体。在初始患病率研究后的四年和十年对受试者进行复查。记录检查期间白内障摘除术的发生情况。
在年轻发病组中,十年间白内障手术的累积发生率为8.3%(95%置信区间,6.2%,10.8%),在老年发病组中为24.9%(95%置信区间,21.3%,28.5%)。多变量分析中,年轻发病组与白内障手术在统计学上显著相关的特征为年龄、糖尿病视网膜病变的严重程度和蛋白尿。在老年发病组中,年龄和胰岛素的使用与风险增加相关。
这些数据表明,白内障手术在糖尿病患者中较为常见。在为糖尿病患者规划医疗保健时需要考虑这一发现。