Frequency and Etiologies of Visual Disturbance After Cataract Surgery Identified in Neuro-Ophthalmology Clinics.
Frequency and Etiologies of Visual Disturbance After Cataract Surgery Identified in Neuro-Ophthalmology Clinics.
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神经眼科诊所确定的白内障手术后视力障碍的频率和病因。
DOI：
10.1097/wno.0000000000001792
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Tamhankar,MadhuraA
中科院分区：
文献类型：
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作者：
Lin,Shuai-Chun;Giang,Angie;Liu,GrantT;Avery,RobertA;Shindler,KennethS;Hamedani,AliG;Ross,AhmaraG;Tamhankar,MadhuraA
背景：探讨神经眼科患者白内障术后视力障碍的发生频率和病因。方法：本研究采用回顾性图表法。回顾了18岁及以上患者在白内障手术后6个月内因新发视力障碍而转介神经眼科诊所的记录。排除了既往有眼神经疾病、眼内手术联合白内障手术或随访不充分的患者。主要观察指标为白内障术后视力障碍的发生频率和病因。我们对一组在我院接受白内障手术的患者进行了二次分析，以确定白内障手术后视力障碍的频率和病因。结果：173例患者符合纳入标准（内部转诊：36/173，外部转诊：137/173）。61%（106/173）为新诊断的神经眼科病因，其中传入障碍21%(36/173)，传出障碍40%（70/173）。36%（62/173）的患者有非神经眼原因，3%（5/173）的患者有导致术后视力障碍的全身性疾病。失代偿性斜视导致复视是白内障术后最常见的神经眼科诊断（50%,53/106）。在我院9年期间接受白内障手术的13715例患者中，36例视力障碍患者中有20例被确定为神经眼科病因，其中85%（17/20）为术后复视。结论：失代偿性斜视导致复视是白内障术后最常见的眼神经视力障碍。白内障手术前应评估详细的病史和眼部排列，以确定患者的风险。
Background:To identify the frequency and etiologies of visual disturbances after cataract surgery in patients referred to Neuro-ophthalmology.Methods:This study is a retrospective chart review. Records of patients 18 years and older referred to neuro-ophthalmology clinics for new-onset visual disturbances within 6 months of cataract surgery were reviewed. Those with pre-existing neuro-ophthalmic disorders, combined intraocular procedures with cataract surgery, or inadequate follow-up were excluded. The main outcome measures were frequency and etiologies of visual disturbances after cataract surgery. Secondary analyses of a cohort of patients who had cataract surgery at our institution were performed to determine the frequency and etiology of visual disturbances after uneventful cataract surgery.Results:One hundred seventy-three patients met the inclusion criteria (internal referral: 36/173, from outside surgeons: 137/173). Sixty-one percent (106/173) were newly diagnosed with neuro-ophthalmic etiologies, including 21%(36/173) with afferent and 40%(70/173) with efferent disorders. Thirty-six percent (62/173) of patients had non neuro-ophthalmic causes and 3%(5/173) had systemic conditions responsible for visual disturbances postoperatively. Decompensated strabismus causing diplopia was the most common neuro-ophthalmic diagnosis after cataract surgery (50%, 53/106). Of the 13,715 patients who had cataract surgery performed at our institution over a 9-year period, 20 of 36 patients referred for visual disturbances were identified with neuro-ophthalmic etiologies of which 85%(17/20) had postoperative diplopia.Conclusions:In our study, decompensated strabismus causing diplopia was the most common neuro-ophthalmic visual disturbance after cataract surgery. Detailed history and ocular alignment should be assessed before cataract surgery to identify patients with the risk.