Outcomes of uveitic cataract and uveitic glaucoma surgery

项目摘要 葡萄膜炎与视力损害有关， 眼内手术-如白内障手术或青光眼手术。拟议准则， 预防视力损害并实现成功的手术结果，包括 术前至少3个月的炎症， 围手术期，然而，有有限的证据，根据实践， 葡萄膜炎性白内障手术和葡萄膜炎性青光眼患者的真实结局 手术眼部疾病的全身免疫抑制治疗（SITE）队列研究是一项 葡萄膜炎患者的丰富数据库（17，907名不同患者，随访超过169，194次）， 炎症状态、接受的药物、手术和其他的详细信息 结果。该数据库包括超过250名18岁以下患有葡萄膜炎的儿童， 白内障手术和100多名接受葡萄膜炎青光眼手术的儿童， 关于儿童葡萄膜炎性白内障和儿童葡萄膜炎性青光眼的文献非常稀少。患者 在手术前6个月内至少接受过一次切口白内障或青光眼手术的患者 包括手术和术后8周后至少两次术后访视， 的分析。本研究的结果可以（1）指导临床医生和患者重新考虑： 在围手术期对患者进行管理，以实现最佳视力， 眼压控制，（2）探讨后续眼内手术的发生率， 特别是在儿童中，这将影响手术的计划和（3）指导手术- 对患者进行手术治疗，以预防眼内炎症， 最佳视觉效果是否让一个孩子无晶状体， 小梁切除术或管分流术与长期眼内压控制相关，因此 保留视觉功能，将有循证指南，通过这种分析。 这些目标符合国家眼科研究所的战略计划和目标， 支持有关致盲性眼病和保护视力的应用临床研究， 特别是目标“建立葡萄膜炎的原因和病因学，并改进其治疗方法， 诊断、治疗和预防。”

Project summary Uveitis is associated with visual impairment and higher incidence of poor outcomes following intraocular surgery—such as cataract surgery or glaucoma surgery. Guidelines proposed to prevent visual impairment and achieve successful surgical outcomes include quiescence of inflammation for atleast 3 months pre-operatively and stringent inflammation control in the perioperative period, however there is limited evidence on which to based practice regarding the real-world outcomes for patients who undergo uveitic cataract surgery and uveitic glaucoma surgery. The Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study is a rich database of uveitis patients (17,907 distinct patients followed over 169,194 visits) with very detailed information on inflammatory status, medications received, surgeries and other outcomes. The database includes over 250 children under the age of 18 who have had uveitic cataract surgery and over 100 children who underwent uveitic glaucoma surgeries, in a field with very sparse literature on pediatric uveitic cataracts and pediatric uveitic glaucoma. Patients who had incisional cataract or glaucoma surgery with at least one visit in the 6 months prior to surgery and at least two post-operative visits beyond 8 weeks postoperatively are included in the analysis. The results from this grant could (1) guide clinicians and patients re: the optimal management of patients in the peri-operative period to achieve best possible visual acuity and intraocular pressure control, (2) explore the incidence of subsequent intraocular surgeries, especially among children, which would impact the planning of surgeries and (3) guide the peri- operative management of patients to prevent intraocular inflammation and subsequently the best visual outcomes. The question of whether to leave a child aphakic or not and whether a trabeculectomy or tube shunt is associated with longer term intraocular pressure control, thus preserving visual function, will have evidence-based guidelines through this analysis. These objectives are responsive to the Strategic Plan and goals of the National Eye Institute, to support applied clinical research concerning blinding eye diseases and preservation of sight, especially the goal “Establish the causes and etiology of uveitis and improve methods for its diagnosis, treatment, and prevention.”