Peng Yong Sim, Paul H. J. Donachie, Alexander C. Day, John C. Buchan
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A logistic regression model was fitted to identify risk factors and calculate their odds ratios (OR) and 95% confidence intervals (CI) for PCR.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>This analysis included 961,208 cataract operations performed on 682,381 patients from 136 participating centres by 3198 surgeons. 9730 (1.01%) of surgeries were complicated by PCR. The median age was 75.7 and 76.7 years for first and second eye surgery respectively, and 5154 (53.0%) were female. The highest risk factors for PCR were less experienced trainee surgeon (OR 3.75, 95% CI 3.33–4.24, <i>p</i> < 0.001), pseudoexfoliation/phacodonesis (OR 3.47, 95% CI 3.05–3.94, <i>p</i> < 0.001), younger males (OR 3.05, 95% CI 2.23–4.16, <i>p</i> < 0.001) and brunescent/white/mature cataract (OR 2.41, 95% CI 2.24–2.60, <i>p</i> < 0.001). Other risk factors identified were glaucoma, worse preoperative VA, previous intravitreal therapy, high myopia, previous vitrectomy, systemic diabetes, diabetic retinopathy, amblyopia, older age, shallower ACD and inability to lie flat and cooperate.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Various surgical, patient and ocular factors increase the risk of PCR during cataract surgery. This risk factor model permits estimation of individualised risks for patients and allows risk-adjustment for surgeons to evaluate their PCR rates based on case complexity.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Royal College of Ophthalmologists’ National Ophthalmology Database study of cataract surgery: Report 17, a risk factor model for posterior capsule rupture\",\"authors\":\"Peng Yong Sim, Paul H. J. Donachie, Alexander C. Day, John C. 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引用次数: 0
摘要
背景/目的建立白内障手术后囊破裂(PCR)的风险因素模型。研究对象/方法纳入2016年4月1日至2022年3月31日期间符合条件的手术,这些手术来自向英国国家白内障审计提供数据的中心,数据完整,包括患者的性别、手术年龄、前房深度(ACD)测量值和术前视力(VA)。该分析包括 136 个参与中心的 961 208 例白内障手术,由 3198 名外科医生为 682 381 名患者实施。9730例(1.01%)手术因 PCR 而变得复杂。第一次和第二次眼科手术的中位年龄分别为 75.7 岁和 76.7 岁,5154 名(53.0%)患者为女性。PCR的最高风险因素是经验较少的实习医生(OR 3.75,95% CI 3.33-4.24,p <0.001)、假性角膜剥脱/角膜松解(OR 3.47,95% CI 3.05-3.94,p <0.001)、年轻男性(OR 3.05,95% CI 2.23-4.16,p <0.001)和白发/白内障(OR 2.41,95% CI 2.24-2.60,p <0.001)。其他风险因素包括青光眼、术前视力较差、既往接受过玻璃体内治疗、高度近视、既往接受过玻璃体切除术、全身性糖尿病、糖尿病视网膜病变、弱视、年龄较大、ACD 较浅以及无法平躺和合作。该风险因素模型可估算出患者的个体化风险,并根据病例的复杂程度对外科医生进行风险调整,以评估其 PCR 发生率。
The Royal College of Ophthalmologists’ National Ophthalmology Database study of cataract surgery: Report 17, a risk factor model for posterior capsule rupture
Background/Objectives
To create a risk factor model for posterior capsule rupture (PCR) during cataract surgery.
Subjects/Methods
Eligible operations between 01/04/2016 and 31/03/2022 from centres supplying data to the UK national cataract audit with complete data including patients’ gender and age at surgery, anterior chamber depth (ACD) measurement and preoperative visual acuity (VA) were included. A logistic regression model was fitted to identify risk factors and calculate their odds ratios (OR) and 95% confidence intervals (CI) for PCR.
Results
This analysis included 961,208 cataract operations performed on 682,381 patients from 136 participating centres by 3198 surgeons. 9730 (1.01%) of surgeries were complicated by PCR. The median age was 75.7 and 76.7 years for first and second eye surgery respectively, and 5154 (53.0%) were female. The highest risk factors for PCR were less experienced trainee surgeon (OR 3.75, 95% CI 3.33–4.24, p < 0.001), pseudoexfoliation/phacodonesis (OR 3.47, 95% CI 3.05–3.94, p < 0.001), younger males (OR 3.05, 95% CI 2.23–4.16, p < 0.001) and brunescent/white/mature cataract (OR 2.41, 95% CI 2.24–2.60, p < 0.001). Other risk factors identified were glaucoma, worse preoperative VA, previous intravitreal therapy, high myopia, previous vitrectomy, systemic diabetes, diabetic retinopathy, amblyopia, older age, shallower ACD and inability to lie flat and cooperate.
Conclusion
Various surgical, patient and ocular factors increase the risk of PCR during cataract surgery. This risk factor model permits estimation of individualised risks for patients and allows risk-adjustment for surgeons to evaluate their PCR rates based on case complexity.
期刊介绍:
Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists.
Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.