Saffire H Krance, Amin Hatamnejad, Rutmila Uddin, Sohel Somani, Eric Tam, Fahmeeda Murtaza, Hannah H Chiu
{"title":"白内障手术后干眼症的医疗利用率、发病率和风险因素。","authors":"Saffire H Krance, Amin Hatamnejad, Rutmila Uddin, Sohel Somani, Eric Tam, Fahmeeda Murtaza, Hannah H Chiu","doi":"10.1016/j.jcjo.2024.08.011","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To quantify post-cataract surgery health care utilization caused by dry eye symptoms (DES) and identify preoperative risk factors and mediators of postoperative DES.</p><p><strong>Setting: </strong>An outpatient surgical centre in Toronto, Canada.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>Included patients had cataract surgery between April 2019 and January 2020, completed a preoperative Dry Eye Questionnaire 5 (DEQ5), and were over age 18.</p><p><strong>Methods: </strong>Data collected included DES risk factors, prophylaxis, and intraoperative and postoperative details. DES health care utilization and prevalence were reported as percentages. Risk of DES follow-up with DES prophylaxis use, and within each DEQ5 severity group, were analyzed with χ<sup>2</sup>-square test of independence and odds ratios. Binomial logistic regression assessed for significance of multiple preoperative and intraoperative risk factors, controlling for one another.</p><p><strong>Results: </strong>Of 1074 patients (46% male, mean age: 71, mean DEQ5: 5.12), 18.1% had at least one nonroutine postoperative appointment due to DES. Patients with moderate/severe DEQ5 scores were 1.843 times likelier to have postoperative DES concerns than those with no/mild scores (CI = 1.307-2.599). Preoperative DES prophylaxis did not reduce DES risk in any severity group. Higher DEQ5 score, female sex, bilateral sequential surgeries, and femtosecond laser-assisted cataract surgery had higher likelihood of postoperative DES (B = 0.054; p < 0.001; B = -0.351; p = 0.037; B = 0.695; p = 0.003; B = 0.491; p = 0.003, respectively).</p><p><strong>Conclusion: </strong>Nearly 1 in 5 patients had DES postcataract surgery, with 1 in 12 requiring one or more nonroutine follow-ups for DES, suggesting substantial health care burden. Current standard preoperative DES treatment may not reduce postoperative DES, and further studies are needed to elucidate why.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Health care utilization, prevalence, and risk factors of dry eyes after cataract surgery.\",\"authors\":\"Saffire H Krance, Amin Hatamnejad, Rutmila Uddin, Sohel Somani, Eric Tam, Fahmeeda Murtaza, Hannah H Chiu\",\"doi\":\"10.1016/j.jcjo.2024.08.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To quantify post-cataract surgery health care utilization caused by dry eye symptoms (DES) and identify preoperative risk factors and mediators of postoperative DES.</p><p><strong>Setting: </strong>An outpatient surgical centre in Toronto, Canada.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>Included patients had cataract surgery between April 2019 and January 2020, completed a preoperative Dry Eye Questionnaire 5 (DEQ5), and were over age 18.</p><p><strong>Methods: </strong>Data collected included DES risk factors, prophylaxis, and intraoperative and postoperative details. DES health care utilization and prevalence were reported as percentages. Risk of DES follow-up with DES prophylaxis use, and within each DEQ5 severity group, were analyzed with χ<sup>2</sup>-square test of independence and odds ratios. Binomial logistic regression assessed for significance of multiple preoperative and intraoperative risk factors, controlling for one another.</p><p><strong>Results: </strong>Of 1074 patients (46% male, mean age: 71, mean DEQ5: 5.12), 18.1% had at least one nonroutine postoperative appointment due to DES. Patients with moderate/severe DEQ5 scores were 1.843 times likelier to have postoperative DES concerns than those with no/mild scores (CI = 1.307-2.599). Preoperative DES prophylaxis did not reduce DES risk in any severity group. 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引用次数: 0
摘要
目的量化白内障手术后因干眼症状(DES)引起的医疗费用使用情况,并确定术前风险因素和术后干眼症状的中介因素:背景:加拿大多伦多一家门诊手术中心:设计:回顾性队列研究:纳入的患者在 2019 年 4 月至 2020 年 1 月期间接受了白内障手术,完成了术前干眼症问卷 5 (DEQ5),且年龄在 18 岁以上:收集的数据包括 DES 风险因素、预防措施以及术中和术后详情。DES医疗利用率和患病率以百分比形式报告。采用χ2-square独立性检验和几率比分析了使用DES预防措施以及在每个DEQ5严重程度组别中DES随访的风险。二项式逻辑回归评估了术前和术中多种风险因素的重要性,并对这些因素进行了相互控制:在1074名患者中(46%为男性,平均年龄:71岁,平均DEQ5:5.12),18.1%的患者因DES至少有一次非例行术后预约。DEQ5中度/重度评分患者术后出现DES问题的可能性是无/轻度评分患者的1.843倍(CI = 1.307-2.599)。术前DES预防并不能降低任何严重程度组的DES风险。DEQ5评分较高、女性、双侧连续手术和飞秒激光辅助白内障手术患者术后发生DES的可能性较高(分别为B = 0.054; p < 0.001; B = -0.351; p = 0.037; B = 0.695; p = 0.003; B = 0.491; p = 0.003):结论:近五分之一的患者在白内障手术后接受了DES治疗,其中十二分之一的患者需要进行一次或多次DES非例行随访,这表明医疗负担沉重。目前标准的术前DES治疗可能无法减少术后DES的发生,需要进一步的研究来阐明原因。
Health care utilization, prevalence, and risk factors of dry eyes after cataract surgery.
Objective: To quantify post-cataract surgery health care utilization caused by dry eye symptoms (DES) and identify preoperative risk factors and mediators of postoperative DES.
Setting: An outpatient surgical centre in Toronto, Canada.
Design: Retrospective cohort study.
Participants: Included patients had cataract surgery between April 2019 and January 2020, completed a preoperative Dry Eye Questionnaire 5 (DEQ5), and were over age 18.
Methods: Data collected included DES risk factors, prophylaxis, and intraoperative and postoperative details. DES health care utilization and prevalence were reported as percentages. Risk of DES follow-up with DES prophylaxis use, and within each DEQ5 severity group, were analyzed with χ2-square test of independence and odds ratios. Binomial logistic regression assessed for significance of multiple preoperative and intraoperative risk factors, controlling for one another.
Results: Of 1074 patients (46% male, mean age: 71, mean DEQ5: 5.12), 18.1% had at least one nonroutine postoperative appointment due to DES. Patients with moderate/severe DEQ5 scores were 1.843 times likelier to have postoperative DES concerns than those with no/mild scores (CI = 1.307-2.599). Preoperative DES prophylaxis did not reduce DES risk in any severity group. Higher DEQ5 score, female sex, bilateral sequential surgeries, and femtosecond laser-assisted cataract surgery had higher likelihood of postoperative DES (B = 0.054; p < 0.001; B = -0.351; p = 0.037; B = 0.695; p = 0.003; B = 0.491; p = 0.003, respectively).
Conclusion: Nearly 1 in 5 patients had DES postcataract surgery, with 1 in 12 requiring one or more nonroutine follow-ups for DES, suggesting substantial health care burden. Current standard preoperative DES treatment may not reduce postoperative DES, and further studies are needed to elucidate why.
期刊介绍:
Official journal of the Canadian Ophthalmological Society.
The Canadian Journal of Ophthalmology (CJO) is the official journal of the Canadian Ophthalmological Society and is committed to timely publication of original, peer-reviewed ophthalmology and vision science articles.