Nathan C Grove, Victoria S Pelak, Karen L Christopher, Brandie D Wagner, Anne M Lynch, Jennifer L Patnaik
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引用次数: 0
Abstract
Purpose: To characterize cataract surgery in people with dementia (PWD) using a cataract surgery outcomes database.
Methods: Demographics, medical and ocular history, surgical characteristics, and postoperative measures were analyzed for differences between PWD and non-PWD cohorts. Patient-level data were analyzed with Fisher's Exact Test, and eye-level data were analyzed with logistic regression using generalized estimating equations to account for correlation of eyes from the same individual.
Results: 507 eyes from 296 PWD were identified using appropriate ICD codes and cross-referenced to a cataract surgery outcomes database containing 12,949 eyes from 7,853 patients who underwent cataract phacoemulsification at a single center between January 2014 and October 2019. PWD were older (p < .001), had shorter duration cataract surgeries (p = .006), and were more likely to have mature cataract (p = .017). The rate of general anesthesia was higher in PWD (p = .005). There were no differences in complication rates between PWD and non-PWD cohorts. Both preoperative best corrected LogMAR distance visual acuity (CDVA) (p < .001) and postoperative CDVA (p < .001) were worse in PWD. CDVA significantly improved in both groups (p < .001); however, the average magnitude of improvement in CDVA was not significantly different between groups (p = .169).
Conclusions: PWD present for cataract surgery at a later age and were more likely to have mature cataracts and general anesthesia, but did not have higher rates of complication, and showed significant improvement in CDVA following surgery. These findings should be encouraging to PWD undergoing counseling for cataract surgery, and for the potential for improved function in PWD.
目的:利用白内障手术结果数据库对痴呆(PWD)患者的白内障手术进行特征分析。方法:分析PWD组和非PWD组的人口统计学、医疗史和眼史、手术特征和术后措施的差异。患者水平数据采用Fisher精确检验分析，眼水平数据采用logistic回归分析，采用广义估计方程来解释同一个体眼睛的相关性。结果:使用适当的ICD代码识别了296名PWD患者的507只眼睛，并交叉参考了2014年1月至2019年10月期间在同一中心接受白内障超声乳化手术的7853名患者的12,949只眼睛的白内障手术结果数据库。PWD患者年龄较大(p = 0.006)，并发成熟性白内障的可能性较大(p = 0.017)。PWD患者全麻率较高(p = 0.005)。PWD组和非PWD组的并发症发生率没有差异。两组术前最佳矫正的LogMAR距离视力(CDVA) (p p p p = .169)。结论:PWD在白内障手术中出现的年龄较晚，更容易出现成熟白内障和全麻，但并发症发生率不高，术后CDVA有明显改善。这些发现应该鼓舞正在接受白内障手术咨询的残疾人士，并有可能改善残疾人士的功能。
期刊介绍：
Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.
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