Cataract Surgery Outcomes in Uveitis: The Multicenter Uveitis Steroid Treatment Trial.
Cataract Surgery Outcomes in Uveitis: The Multicenter Uveitis Steroid Treatment Trial.
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DOI：
10.1016/j.ophtha.2015.09.022
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发表时间：
2016-01
期刊：
影响因子：
13.7
通讯作者：
Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study Research Group
中科院分区：
文献类型：
--
作者：
Sen HN;Abreu FM;Louis TA;Sugar EA;Altaweel MM;Elner SG;Holbrook JT;Jabs DA;Kim RY;Kempen JH;Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study Research Group
在多中心葡萄膜炎类固醇治疗（MUST）试验中，评估接受氟西诺酮植入物或口服皮质类固醇和免疫抑制系统治疗的白内障手术的视力结果。嵌套前瞻性队列研究纳入患者随机临床试验。在MUST试验的前2年随访期间接受白内障手术的患者。术后3、6、9个月采用对数视力表评估白内障手术的视力结果。使用混合效应模型评估视力随时间的变化。最佳矫正视力。在排除同时进行白内障手术和种植体手术的眼后，在MUST试验的479只眼中，82名患者的117只眼（28只为全身组，89只为种植体组）在前2年的随访中接受了白内障手术。总体而言，从术前到3个月的随访，视力增加了23个字母（95%置信区间[CI]， 17-29个字母；P < 0.001），并在9个月的随访中保持稳定。由于无法对玻璃体浑浊分级，推断患有更严重白内障的眼睛在手术前玻璃体浑浊分级的眼睛（95% CI， 9-18个字母，P < 0.001） 3个月后增加了42个字母（95% CI， 34-56个字母，P < 0.001），弥补了术前就诊时-45个字母的初始差异（95% CI， -56 -34个字母，P < 0.001）。黑人、葡萄膜炎发病时间较长、低斜视与术前视力差相关（P < 0.05），但对术后恢复无影响（P < 0.05，相互作用检验）。在校正了其他危险因素后，两个治疗组之间的视力改善无显著差异（植入与全身治疗，2个字母；95% CI， -10至15个字母；P = 0.70）。白内障手术对接受氟西诺酮植入物或标准全身治疗的葡萄膜炎患者的视力有显著、持续和相似的改善。
To assess the visual outcomes of cataract surgery in eyes that received fluocinolone acetonide implant or systemic therapy with oral corticosteroids and immunosuppression during the Multicenter Uveitis Steroid Treatment (MUST) Trial. Nested prospective cohort study of patients enrolled in a randomized clinical trial. Patients that underwent cataract surgery during the first 2 years of follow-up in the MUST Trial. Visual outcomes of cataract surgery were evaluated 3, 6, and 9 months after surgery using logarithmic visual acuity charts. Change in visual acuity over time was assessed using a mixed-effects model. Best-corrected visual acuity. After excluding eyes that underwent cataract surgery simultaneously with implant surgery, among the 479 eyes in the MUST Trial, 117 eyes (28 eyes in the systemic, 89 in the implant group) in 82 patients underwent cataract surgery during the first 2 years of follow-up. Overall, visual acuity increased by 23 letters from the preoperative visit to the 3-month visit (95% confidence interval [CI], 17–29 letters; P < 0.001) and was stable through 9 months of follow-up. Eyes presumed to have a more severe cataract, as measured by inability to grade vitreous haze, gained an additional 42 letters (95% CI, 34–56 letters; P < 0.001) beyond the 13-letter gain in eyes that had gradable vitreous haze before surgery (95% CI, 9–18 letters; P < 0.001) 3 months after surgery, making up for an initial difference of –45 letters at the preoperative visit (95% CI, –56 to –34 letters; P < 0.001). Black race, longer time from uveitis onset, and hypotony were associated with worse preoperative visual acuity (P < 0.05), but did not affect postsurgical recovery (P > 0.05, test of interaction). After adjusting for other risk factors, there was no significant difference in the improvement in visual acuity between the 2 treatment groups (implant vs. systemic therapy, 2 letters; 95% CI, –10 to 15 letters; P = 0.70). Cataract surgery resulted in substantial, sustained, and similar visual acuity improvement in the eyes of patients with uveitis treated with the fluocinolone acetonide implant or standard systemic therapy.
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影响因子：
4.2
作者：
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