■报告人口统计学的发生率并进行评估,眼部合并症,美国眼科学会IRIS®注册(IntelligentResearchinSight)白内障手术后孔源性视网膜脱离(RRD)和视网膜撕裂(RT)的术中因素。
■回顾性队列研究。
■在2014年至2017年期间接受白内障手术的年龄≥40岁的患者。
■多变量逻辑回归用于评估人口统计,合并症,以及与白内障术后RRD和RT相关的术中因素。
■白内障手术1年内RRD或RT的发生率和危险因素。
■包括1983712例患者的3177195只眼,在白内障手术后1年内,6690(0.21%)发展为RRD,5489(0.17%)发展为无RRD的RT。多变量logistic回归比值比(ORs)显示RRD和RT的风险增加,分别,在男性中(OR3.15;95%置信区间[CI],2.99-3.32;P<0.001和1.79;95%CI,1.70-1.89;P<0.001),与年龄>70岁的患者相比,年龄更小,RRD在40至50岁达到峰值(8.61;95%CI,7.74-9.58;P<0.001),RT在50至60岁达到峰值(2.74;95%CI,2.52-2.98;P<0.001)。对于晶格变性(LD)的手术眼,观察到RRD的几率增加(10.53;95%CI,9.82-11.28;P<0.001),过成熟白内障(1.61;95%CI,1.06-2.45;P=0.03),复杂白内障手术(1.52;95%CI,1.4-1.66;P<0.001),玻璃体后脱离(PVD)(1.24;95%CI,1.15-1.34;P<0.001),高度近视(1.2;95%CI,1.14-1.27;P<0.001)。晶格变性具有最高的RT几率(43.86;95%CI,41.39-46.49;P<0.001)。
■在IRIS注册表中,RRD发生在手术后1年内年龄>40岁的患者的约500例白内障手术中。LD的存在使手术后RRD和RT的几率最高。RRD的其他危险因素包括男性,年龄较小,过度成熟的白内障,PVD,和高度近视。这些数据在白内障手术的知情同意过程中可能很有用,并有助于识别视网膜并发症风险较高的患者。
■作者对本文讨论的任何材料都没有专有或商业利益。
UNASSIGNED: To report the incidence of and evaluate demographic, ocular comorbidities, and intraoperative factors for rhegmatogenous retinal detachment (RRD) and retinal tear (RT) after cataract surgery in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight).
UNASSIGNED: Retrospective cohort study.
UNASSIGNED: Patients aged ≥ 40 years who underwent cataract surgery between 2014 and 2017.
UNASSIGNED: Multivariable logistic regression was used to evaluate demographic, comorbidity, and intraoperative factors associated with RRD and RT after cataract surgery.
UNASSIGNED: Incidence and risk factors for RRD or RT within 1 year of cataract surgery.
UNASSIGNED: Of the 3 177 195 eyes of 1 983 712 patients included, 6690 (0.21%) developed RRD and 5489 (0.17%) developed RT without RRD within 1 year after cataract surgery. Multivariable logistic regression odds ratios (ORs) showed increased risk of RRD and RT, respectively, among men (OR 3.15; 95% confidence interval [CI], 2.99-3.32; P < 0.001 and 1.79; 95% CI, 1.70-1.89; P < 0.001), and younger ages compared with patients aged > 70, peaking at age 40 to 50 for RRD (8.61; 95% CI, 7.74-9.58; P < 0.001) and age 50 to 60 for RT (2.74; 95% CI, 2.52-2.98; P < 0.001). Increased odds of RRD were observed for procedure eyes with lattice degeneration (LD) (10.53; 95% CI, 9.82-11.28; P < 0.001), hypermature cataract (1.61; 95% CI, 1.06-2.45; P = 0.03), complex cataract surgery (1.52; 95% CI, 1.4-1.66; P < 0.001), posterior vitreous detachment (PVD) (1.24; 95% CI, 1.15-1.34; P < 0.001), and high myopia (1.2; 95% CI, 1.14-1.27; P < 0.001). Lattice degeneration conferred the highest odds of RT (43.86; 95% CI, 41.39-46.49; P < 0.001).
UNASSIGNED: In the IRIS Registry, RRD occurs in approximately 1 in 500 cataract surgeries in patients aged > 40 years within 1 year of surgery. The presence of LD conferred the highest odds for RRD and RT after surgery. Additional risk factors for RRD included male gender, younger age, hypermature cataract, PVD, and high myopia. These data may be useful during the informed consent process for cataract surgery and help identify patients at a higher risk of retinal complications.
UNASSIGNED: The author(s) have no proprietary or commercial interest in any materials discussed in this article.