Norregaard J C, Hindsberger C, Alonso J, Bellan L, Bernth-Petersen P, Black C, Dunn E, Andersen T F, Espallargues M, Anderson G F
Institute of Public Health, University of Copenhagen, Denmark.
Arch Ophthalmol. 1998 Aug;116(8):1095-100. doi: 10.1001/archopht.116.8.1095.
To compare visual outcomes obtained following cataract surgery in 4 sites in North America and Europe where considerable differences in the organization of care and patterns of clinical practice have been previously described.
Patients scheduled for first eye-cataract surgery and aged 50 years or older were enrolled consecutively in a prospective multicenter study that collected clinical and patient interview data preoperatively and postoperatively. From the United States, 772 patients were enrolled; from the Province of Manitoba (Canada), 159; from Denmark, 291; and from the City of Barcelona (Spain), 200. Preoperative and 4-month postoperative visual acuity was obtained for 92% of the patients (n = 1291).
The mean 4-month postoperative visual acuity of eyes operated on varied significantly across the 4 sites (P < .001) and had the following Snellen decimal fraction measurements: 0.49 in Barcelona, 0.65 in Denmark, 0.66 in Manitoba, and 0.74 in the United States. However, while crude visual acuity outcome figures varied significantly, no significant difference was observed across the 4 sites regarding the risk of poorer visual outcome after controlling for differences in age, preoperative visual acuity, and general health status for patients with no ocular comorbidity. Older age, poorer preoperative visual acuity, poorer preoperative general health status, and coexisting ocular comorbidity were predictors of a poorer visual outcome.
A previously identified variation in treatment modalities across the 4 sites did not seem to affect patients' visual acuity outcomes.
比较北美和欧洲4个地点白内障手术后的视觉效果，此前已描述过这些地点在护理组织和临床实践模式方面存在显著差异。
计划进行首次白内障手术且年龄在50岁及以上的患者连续纳入一项前瞻性多中心研究，该研究在术前和术后收集临床及患者访谈数据。在美国，纳入772例患者；在加拿大曼尼托巴省，纳入159例；在丹麦，纳入291例；在西班牙巴塞罗那市，纳入200例。92%的患者（n = 1291）获得了术前和术后4个月的视力。
4个地点接受手术的眼睛术后4个月的平均视力有显著差异（P <.001），其Snellen小数视力测量结果如下：巴塞罗那为0.49，丹麦为0.65，曼尼托巴为0.66，美国为0.74。然而，虽然粗略的视力结果数字有显著差异，但在控制无眼部合并症患者的年龄、术前视力和一般健康状况差异后，4个地点在视力较差结果的风险方面未观察到显著差异。年龄较大、术前视力较差、术前一般健康状况较差以及存在眼部合并症是视力较差结果的预测因素。
先前确定的4个地点治疗方式的差异似乎并未影响患者的视力结果。
