PDF(Pubmed)
Abstract：
To retrospectively study impact of preoperative posterior segment evaluation on surgical intervention in camp patients recruited for cataract surgery in Gujarat India.
Retrospective analysis of six months data collected from hospital electronic medical record (EMR) system of 9820 admitted patients recruited from screening camp for cataract surgery from 1/10/2019 to 31/3/2020 in Tertiary Eye Hospital in Gujarat, India, has been done. Comprehensive clinical evaluation, of both anterior and posterior segment which included detailed history; best corrected visual acuity (BCVA); intraocular pressure measurement with non-contact tonometer (NCT) and when required with Goldman applanation tonometer; slit lamp examination; and fundus examination with + 90 diopter lens as well as indirect ophthalmoscope as and when indicated. In case there was no view of retina, a B-scan ultrasound was done to rule out any posterior segment pathology. Immediate surgical intervention done was assessed and results analyzed in percentage.
Cataract surgery was advised for 8390 patients (85.43%). Surgical intervention for management of glaucoma was done for 68 patients (0.692%). Retina intervention was done for 86 patients. Posterior segment evaluation changed immediate surgical plane of management for 154 (1.57%) patients.
Comprehensive clinical evaluation is economical and should be mandatory especially in community services as comorbid conditions like glaucoma, diabetic retinopathy, retinal vein occlusion, and other varied posterior segment diseases contribute significantly to visual disability in elderly age group. It is difficult to follow these patients later if manageable comorbidity is not informed about and if indicated dealt simultaneously for visual rehabilitation of patient.
Retrospective analysis of six months data collected from hospital electronic medical record (EMR) system of 9820 admitted patients recruited from screening camp for cataract surgery from 1/10/2019 to 31/3/2020 in Tertiary Eye Hospital in Gujarat, India, has been done. Comprehensive clinical evaluation, of both anterior and posterior segment which included detailed history; best corrected visual acuity (BCVA); intraocular pressure measurement with non-contact tonometer (NCT) and when required with Goldman applanation tonometer; slit lamp examination; and fundus examination with + 90 diopter lens as well as indirect ophthalmoscope as and when indicated. In case there was no view of retina, a B-scan ultrasound was done to rule out any posterior segment pathology. Immediate surgical intervention done was assessed and results analyzed in percentage.
Cataract surgery was advised for 8390 patients (85.43%). Surgical intervention for management of glaucoma was done for 68 patients (0.692%). Retina intervention was done for 86 patients. Posterior segment evaluation changed immediate surgical plane of management for 154 (1.57%) patients.
Comprehensive clinical evaluation is economical and should be mandatory especially in community services as comorbid conditions like glaucoma, diabetic retinopathy, retinal vein occlusion, and other varied posterior segment diseases contribute significantly to visual disability in elderly age group. It is difficult to follow these patients later if manageable comorbidity is not informed about and if indicated dealt simultaneously for visual rehabilitation of patient.
摘要：
■回顾性研究在印度古吉拉特邦招募的白内障手术患者中，术前后段评估对手术干预的影响。
■对从2019年1月10日至2020年3月31日在古吉拉特邦三级眼科医院从白内障手术筛查营招募的9820名住院患者的医院电子病历（EMR）系统收集的六个月数据进行回顾性分析，印度,已经完成了。综合临床评价,前段和后段，包括详细的病史；最佳矫正视力（BCVA）；使用非接触式眼压计（NCT）测量眼压，并在需要时使用Goldman压平眼压计测量眼压；裂隙灯检查；以及使用+90屈光度晶状体以及间接检眼镜进行眼底检查。如果没有视网膜的视野，进行了B超检查以排除任何后段病理。评估立即进行的手术干预，并以百分比分析结果。
■建议对8390例患者（85.43%）进行白内障手术。对68例患者（0.692%）进行了青光眼治疗的手术干预。对86例患者进行视网膜干预。后段评估改变了154例（1.57％）患者的即时手术治疗平面。
■综合临床评估是经济的，应该是强制性的，特别是在社区服务中，如青光眼等合并症，糖尿病视网膜病变，视网膜静脉阻塞,和其他各种后段疾病对老年人群的视力残疾有显著贡献。如果未告知可控制的合并症，并且如果需要同时处理以进行患者的视觉康复，则很难在以后跟踪这些患者。
■对从2019年1月10日至2020年3月31日在古吉拉特邦三级眼科医院从白内障手术筛查营招募的9820名住院患者的医院电子病历（EMR）系统收集的六个月数据进行回顾性分析，印度,已经完成了。综合临床评价,前段和后段，包括详细的病史；最佳矫正视力（BCVA）；使用非接触式眼压计（NCT）测量眼压，并在需要时使用Goldman压平眼压计测量眼压；裂隙灯检查；以及使用+90屈光度晶状体以及间接检眼镜进行眼底检查。如果没有视网膜的视野，进行了B超检查以排除任何后段病理。评估立即进行的手术干预，并以百分比分析结果。
■建议对8390例患者（85.43%）进行白内障手术。对68例患者（0.692%）进行了青光眼治疗的手术干预。对86例患者进行视网膜干预。后段评估改变了154例（1.57％）患者的即时手术治疗平面。
■综合临床评估是经济的，应该是强制性的，特别是在社区服务中，如青光眼等合并症，糖尿病视网膜病变，视网膜静脉阻塞,和其他各种后段疾病对老年人群的视力残疾有显著贡献。如果未告知可控制的合并症，并且如果需要同时处理以进行患者的视觉康复，则很难在以后跟踪这些患者。
