GLAUCOMA SURGICAL OUTCOMES STUDY

本研究计划的主要目的是降低青光眼手术的发病率。这一目标将通过确定滤过手术、引流装置手术和环破坏手术后眼内炎、脉络膜上出血、低眼压和严重视力丧失的危险因素来实现。数据将在4年内从200名眼科医生那里收集，这些医生每年总共进行2万例手术。那些被确定为手术并发症的眼睛的医疗记录将与每个病例的匹配对照一起进行审查。将从每个图表中提取有关种族、年龄、性别、抗纤维化药物的使用、屈光不正、晶状体状态、手术类型、额外手术或程序、术后眼科药物、囊泡渗漏或睑炎的存在以及全身性疾病的信息。数据将使用单变量、双变量和条件逻辑回归分析进行分析。根据这些信息，我们将确定手术严重并发症的危险因素。此外，我们将收集这些并发症在视力、视野和眼压方面的结果信息，并将结果与患者和眼部特征以及治疗相关联。该研究的结果可能允许医生通过改变手术适应症、手术技术和术后随访来降低青光眼手术的发病率。

The broad objective of this research proposal is to decrease the morbidity of glaucoma surgery. This objective will be accomplished by achieving the specific aim of determining the risk factors for endophthalmitis, suprachoroidal hemorrhage, hypotony and severe vision loss following filtration surgery, drainage device surgery, and cyclodestructive procedures. Data will be collected prospectively for 4 years from 200 ophthalmologists performing a total of 20,000 operations a year. The medical records of those eyes identified with surgical complications will be reviewed along with matched controls for each case. Information will be abstracted from each chart concerning race, age, gender, use of antifibrosis agents, refractive error, lens status, type of surgery, additional surgery or procedures, post-operative ocular medications, presence of bleb leak or blepharitis, and systemic diseases. The data will be analyzed utilizing univariate, bi-variate, and conditional logistic regression analysis. From this information we will determine the risk factors for the serious complications of surgery. Furthermore, we will collect information on the outcomes of these complications in terms of visual acuity, visual field, and intraocular pressure, and correlate the outcome with patient and ocular characteristics as well as treatment. The results of the study may allow physicians to reduce the morbidity of glaucoma surgery by altering their indications for surgery, surgical technique, and postoperative follow-up.