PDF(Pubmed)
Abstract：
UNASSIGNED: To assess the risk for uveitis, pseudophakic cystoid macular edema (PCME), and posterior capsular opacification (PCO) associated with the use of pupil expansion devices in cataract surgery.
UNASSIGNED: A retrospective comparative cohort study.
UNASSIGNED: Patients who underwent routine cataract surgery with and without pupil expansion devices at the Department of Ophthalmology, Bristol Eye Hospital, UK, between January 2008 and December 2017.
UNASSIGNED: This study included 39,460 eyes operated without a pupil expansion device and 699 eyes operated with the device. Odds ratios for uveitis and PCME when using a pupil expansion device were calculated using univariate and multivariate regression analysis, having age, gender, diabetes, pseudoexfoliation, and pupil expansion device as independent variables. Multivariate Cox regression controlling for age and gender was used to estimate hazard ratios (HR) for Nd : YAG laser capsulotomies.
UNASSIGNED: Postoperative uveitis and PCME were reported in 3.9% and 2.7% of the eyes operated with a pupil expansion device compared to 2.3% and 1.3% operated without the device (p=0.005 and p=0.002, respectively). In univariate regression analysis, eyes with pupil expansion devices showed a higher risk of postoperative uveitis or PMCE after cataract surgery (OR 1.88, 95%CI 1.39-2.55, p<0.001). In multivariate regression analysis, the risk for PMCE was greater among diabetic patients and in eyes with a pupil expansion device than in those without (OR 1.50, 95%CI 1.24-1.83, P<0.001; OR 1.90, 95%CI 1.16-3.11, P=0.01). In Cox regression analysis adjusted for the patient\'s age and gender, the use of a pupil expansion device was associated with higher Nd : YAG laser capsulotomy rates (HR 1.316, 95%CI 1.011-1.714, P=0.041).
UNASSIGNED: In our large cohort study, the use of pupil expansion devices in cataract surgery was associated with an increased risk of major postoperative complications. Effective anti-inflammatory treatment and follow-up are warranted in eyes operated with a pupil expansion device.
UNASSIGNED: A retrospective comparative cohort study.
UNASSIGNED: Patients who underwent routine cataract surgery with and without pupil expansion devices at the Department of Ophthalmology, Bristol Eye Hospital, UK, between January 2008 and December 2017.
UNASSIGNED: This study included 39,460 eyes operated without a pupil expansion device and 699 eyes operated with the device. Odds ratios for uveitis and PCME when using a pupil expansion device were calculated using univariate and multivariate regression analysis, having age, gender, diabetes, pseudoexfoliation, and pupil expansion device as independent variables. Multivariate Cox regression controlling for age and gender was used to estimate hazard ratios (HR) for Nd : YAG laser capsulotomies.
UNASSIGNED: Postoperative uveitis and PCME were reported in 3.9% and 2.7% of the eyes operated with a pupil expansion device compared to 2.3% and 1.3% operated without the device (p=0.005 and p=0.002, respectively). In univariate regression analysis, eyes with pupil expansion devices showed a higher risk of postoperative uveitis or PMCE after cataract surgery (OR 1.88, 95%CI 1.39-2.55, p<0.001). In multivariate regression analysis, the risk for PMCE was greater among diabetic patients and in eyes with a pupil expansion device than in those without (OR 1.50, 95%CI 1.24-1.83, P<0.001; OR 1.90, 95%CI 1.16-3.11, P=0.01). In Cox regression analysis adjusted for the patient\'s age and gender, the use of a pupil expansion device was associated with higher Nd : YAG laser capsulotomy rates (HR 1.316, 95%CI 1.011-1.714, P=0.041).
UNASSIGNED: In our large cohort study, the use of pupil expansion devices in cataract surgery was associated with an increased risk of major postoperative complications. Effective anti-inflammatory treatment and follow-up are warranted in eyes operated with a pupil expansion device.
摘要：
■为了评估葡萄膜炎的风险，假晶状体囊样黄斑水肿（PCME），与白内障手术中使用瞳孔扩张装置相关的后囊混浊(PCO)。
■一项回顾性队列研究。
■在眼科接受常规白内障手术且有无扩瞳装置的患者，布里斯托尔眼科医院,英国,2008年1月至2017年12月。
■这项研究包括在没有瞳孔扩张装置的情况下操作的39,460只眼睛和使用该装置操作的699只眼睛。使用单变量和多变量回归分析计算使用瞳孔扩张装置时葡萄膜炎和PCME的几率。年龄,性别,糖尿病,假性剥脱,和瞳孔扩展装置作为独立变量。使用年龄和性别的多变量Cox回归来估计Nd：YAG激光囊切开术的风险比（HR）。
■术后葡萄膜炎和PCME分别为3.9%和2.7%，而未使用扩瞳装置的患者为2.3%和1.3%（分别为p=0.005和p=0.002）。在单变量回归分析中，使用扩瞳装置的眼睛在白内障手术后出现术后葡萄膜炎或PMCE的风险较高(OR1.88,95CI1.39-2.55,p<0.001).在多元回归分析中，糖尿病患者和有扩瞳装置的患者发生PMCE的风险高于无扩瞳装置的患者(OR1.50,95CI1.24-1.83,P<0.001;OR1.90,95CI1.16-3.11,P=0.01).在Cox回归分析中，调整了患者的年龄和性别，使用瞳孔扩张装置与较高的Nd:YAG激光囊切开率相关(HR1.316,95CI1.011~1.714,P=0.041).
■在我们的大型队列研究中，在白内障手术中使用瞳孔扩张装置与主要术后并发症的风险增加相关.在使用瞳孔扩张装置操作的眼睛中，需要进行有效的抗炎治疗和随访。
■一项回顾性队列研究。
■在眼科接受常规白内障手术且有无扩瞳装置的患者，布里斯托尔眼科医院,英国,2008年1月至2017年12月。
■这项研究包括在没有瞳孔扩张装置的情况下操作的39,460只眼睛和使用该装置操作的699只眼睛。使用单变量和多变量回归分析计算使用瞳孔扩张装置时葡萄膜炎和PCME的几率。年龄,性别,糖尿病,假性剥脱,和瞳孔扩展装置作为独立变量。使用年龄和性别的多变量Cox回归来估计Nd：YAG激光囊切开术的风险比（HR）。
■术后葡萄膜炎和PCME分别为3.9%和2.7%，而未使用扩瞳装置的患者为2.3%和1.3%（分别为p=0.005和p=0.002）。在单变量回归分析中，使用扩瞳装置的眼睛在白内障手术后出现术后葡萄膜炎或PMCE的风险较高(OR1.88,95CI1.39-2.55,p<0.001).在多元回归分析中，糖尿病患者和有扩瞳装置的患者发生PMCE的风险高于无扩瞳装置的患者(OR1.50,95CI1.24-1.83,P<0.001;OR1.90,95CI1.16-3.11,P=0.01).在Cox回归分析中，调整了患者的年龄和性别，使用瞳孔扩张装置与较高的Nd:YAG激光囊切开率相关(HR1.316,95CI1.011~1.714,P=0.041).
■在我们的大型队列研究中，在白内障手术中使用瞳孔扩张装置与主要术后并发症的风险增加相关.在使用瞳孔扩张装置操作的眼睛中，需要进行有效的抗炎治疗和随访。
