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Are there sex-based disparities in cataract surgery?
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作者 Matthew D.Geiger Anne M.Lynch +6 位作者 Alan G.Palestine Nathan C.Grove Karen L.Christopher richard s.davidson Michael J.Taravella Naresh Mandava Jennifer L.Patnaik 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第1期137-143,共7页
AIM:To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery.METHODS:This was a retrospective study of patien... AIM:To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery.METHODS:This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of Medicine.Data collected included the patient’s health history,ocular comorbidities,operative and post-operative complications,and the post-operative best corrected visual acuity(BCVA).The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the study.RESULTS:A total of 11977 eyes from 7253 patients were included in the study.Ocular comorbidities differed by sex,with males having significantly higher percentages of traumatic cataracts(males 0.7%vs females 0.1%),prior ocular surgery(6.7%vs 5.5%),and mature cataracts(2.8%vs 1.9%).Conversely,females had significantly higher rates of pseudoexfoliation(2.0%vs 3.2%).In unadjusted analysis,males had higher rates of posterior capsular rupture(0.8%vs 0.4%)and vitreous loss(1.0%vs 0.6%),but this difference was not significant after adjustment for confounders.Males had a significantly increased risk of post-operative retinal detachment,but in multivariable analysis this was no longer significant.Males were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy for posterior capsule opacification(OR=0.8,95%CI=0.7-0.9,P=0.0005).The BCVA was slightly worse for males pre-operatively;but post-operatively,both sexes exhibited similar visual acuity of Snellen equivalent 20/25.CONCLUSION:The study finds that in a cohort of patients presenting for cataract surgery,sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for males.However,observed surgical complication rates exhibit almost no difference by sex after adjusting for pre-operative differences and post-operative BCVA is similar between sexes. 展开更多
关键词 cataract surgery sex-based disparity PHACOEMULSIFICATION outcomes
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Iris manipulation during phacoemulsification:intraoperative and postoperative complications 被引量:2
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作者 Eric R.Williams Jennifer L.Patnaik +4 位作者 D.Claire Miller Anne M.Lynch richard s.davidson Malik Y.Kahook Leonard K.Seibold 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2021年第5期676-683,共8页
AIM:To quantify intraoperative and postoperative complications in complex phacoemulsification cataract extraction(phacoemulsification)with iris manipulation compared to non-complex and complex phacoemulsification with... AIM:To quantify intraoperative and postoperative complications in complex phacoemulsification cataract extraction(phacoemulsification)with iris manipulation compared to non-complex and complex phacoemulsification without iris manipulation.METHODS:All phacoemulsification cases at the University of Colorado between January 1,2014,and June 30,2017 were included.Exclusion criteria for the primary outcome of intraoperative complications were planned combination surgery and eyes with less than 28 d followup.Exclusion criteria for the secondary outcomes of postoperative complications were unplanned additional surgery,and chronic steroid eye drop use prior to surgery.Data including sex,race/ethnicity,surgery length,visual acuity,intraoperative and postoperative complications,and intraocular pressures(IOP)were collected and analyzed utilizing general linear and Logistic regression modeling.RESULTS:The medical records of 5772 eyes were reviewed(500 complex without iris manipulation,367 with iris manipulation).The number of any intraoperative complication in the complex with iris manipulation and complex without iris manipulation groups was 15(4.1%)and 26(5.2%),respectively,compared to 41(0.8%)in the non-complex group.Postoperative inflammation was found in 135(2.8%)non-complex cases,20(4.1%)complex cases without iris manipulation,and 20(5.6%)complex cases with iris manipulation.The adjusted odds ratio of postoperative inflammation in phacoemulsification with iris manipulation compared to non-complex was 2.3(95%CI:1.3-4.0,P=0.005).The rate of IOP spikes>10 mm Hg was significantly greater in cases with iris manipulation(P=0.001).CONCLUSION:Complex cases have more intraoperative complications.However,only complex cases with iris manipulation led to increase rates of postoperative inflammation and IOP spikes>10 mm Hg. 展开更多
关键词 PHACOEMULSIFICATION iris manipulation INFLAMMATION
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