Tobacman J K, Zimmerman B, Lee P, Hilborne L, Kolder H, Brook R H
University of Iowa, Iowa City, USA.
Ophthalmology. 1998 Sep;105(9):1745-50. doi: 10.1016/S0161-6420(98)99048-0.
This study aimed to determine the relationship between visual function impairment in 776 patients who had extracapsular cataract extraction with posterior chamber intraocular lens implantation and gender, age, preoperative visual acuity (VA) of both the operative and the contralateral eye, and presence of other ocular disease in the operative eye.
Retrospective cross-sectional study.
1139 patients whose medical records were abstracted and who had cataract surgery performed at 1 of 10 participating academic medical centers in 1990.
In the 776 patients who had explicit statements about impairment of visual function documented in their medical records, univariate and multivariable logistic analyses were used to assess the above relationship.
The most severe visual functional deficit that justified the cataract operation varied in relation to gender, age, and VA. On bivariate analysis, men were more likely to have impairment with employment, driving, and glare, whereas women were more likely to have impairment with activities of daily living and recreational activities. Significant findings between visual impairment and the independent variables from the logistic regression models included: (1) employment limitation and male gender (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.08-3.40); (2) employment limitation and younger age (OR, 0.12; 95% CI, 0.050-0.28 for ages 70-79); (3) recreational impairment and older age (OR, 2.77; 95% CI, 1.64-4.70 for ages 80+); (4) impairment in performing activities of daily living and female gender (OR, 0.72; 95% CI, 0.53-0.98 for male gender); (5) impairment in performing activities of daily living and worse VA in the operative eye (OR, 5.13; 95% CI, 2.93-9.00 for VA < 20/100); (6) glare-associated impairment and younger age (OR, 0.40; 95% CI, 0.24-0.69 for age 80+); and (7) glare-associated impairment and better VA (OR, 0.16; 95% CI, 0.067-0.38 for VA < 20/100).
When deciding whether to perform cataract surgery, functional impairment must be considered in relation to the age and the gender of the patient, for the type of functional impairment varies in association with age and gender.
本研究旨在确定776例行白内障囊外摘除联合后房型人工晶状体植入术患者的视觉功能损害与性别、年龄、术眼及对侧眼的术前视力（VA），以及术眼是否存在其他眼部疾病之间的关系。
回顾性横断面研究。
1139例病历被提取且于1990年在10家参与研究的学术医疗中心之一接受白内障手术的患者。
在776例病历中有明确视觉功能损害记录的患者中，采用单因素和多因素逻辑回归分析来评估上述关系。
证明白内障手术合理的最严重视觉功能缺陷因性别、年龄和视力而异。在双变量分析中，男性在工作、驾驶和眩光方面更易出现损害，而女性在日常生活活动和娱乐活动方面更易出现损害。视觉损害与逻辑回归模型中的自变量之间的显著发现包括：（1）工作受限与男性性别（比值比[OR]，1.92；95%置信区间[CI]，1.08 - 3.40）；（2）工作受限与较年轻年龄（70 - 79岁时，OR，0.12；95% CI，0.050 - 0.28）；（3）娱乐活动受损与较年长年龄（80岁及以上时，OR，2.77；95% CI，1.64 - 4.70）；（4）日常生活活动能力受损与女性性别（男性时，OR，0.72；95% CI，0.53 - 0.98）；（5）日常生活活动能力受损与术眼较差视力（视力<20/100时，OR，5.13；95% CI，2.93 - 9.00）；（6）眩光相关损害与较年轻年龄（80岁及以上时，OR，0.40；95% CI，0.24 - 0.69）；以及（7）眩光相关损害与较好视力（视力<20/100时，OR，0.16；95% CI，0.067 - 0.38）。
在决定是否进行白内障手术时，必须考虑患者年龄和性别的功能损害情况，因为功能损害的类型会因年龄和性别而有所不同。
