Daniel M. Vu MD , Tobias Elze PhD , Joan W. Miller MD , Alice C. Lorch MD, MPH , Deborah K. VanderVeen MD , Isdin Oke MD
{"title":"IRIS®注册中心儿童白内障手术后青光眼诊断和手术干预的风险因素。","authors":"Daniel M. Vu MD , Tobias Elze PhD , Joan W. Miller MD , Alice C. Lorch MD, MPH , Deborah K. VanderVeen MD , Isdin Oke MD","doi":"10.1016/j.ogla.2023.08.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>To compare demographic and clinical factors associated with glaucoma following cataract surgery<span><span> (GFCS) and glaucoma surgery rates between infants, toddlers, and older children using a large, </span>ophthalmic registry.</span></p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Participants</h3><p>Patients in the IRIS® Registry (Intelligent Research in Sight) who underwent cataract surgery at ≤ 17 years old and between January 1, 2013 and December 31, 2020.</p></div><div><h3>Methods</h3><p><span>Glaucoma diagnosis and procedural codes were extracted from the electronic health records of practices participating in the IRIS Registry. Children with glaucoma diagnosis or surgery before cataract removal were excluded. The Kaplan–Meier estimator was used to determine the cumulative probability of GFCS diagnosis and glaucoma surgery after cataract surgery. Multivariable </span>Cox regression was used to identify factors associated with GFCS and glaucoma surgery.</p></div><div><h3>Main Outcome Measures</h3><p>Cumulative probability of glaucoma diagnosis and surgical intervention within 5 years after cataract surgery.</p></div><div><h3>Results</h3><p><span>The study included 6658 children (median age, 10.0 years; 46.2% female). The 5-year cumulative probability of GFCS was 7.1% (95% confidence interval [CI], 6.1%–8.1%) and glaucoma surgery was 2.6% (95% CI, 1.9%–3.2%). The 5-year cumulative probability of GFCS for children aged < 1 year was 22.3% (95% CI, 15.7%–28.4%). Risk factors for GFCS included aphakia (hazard ratio [HR], 2.63; 95% CI, 1.96–3.57), unilateral cataract (HR, 1.48; 95% CI, 1.12–1.96), and Black race (HR, 1.61; 95% CI, 1.12–2.32). The most common surgery was glaucoma drainage device insertion (32.6%), followed by angle surgery (23.3%), cyclophotocoagulation (15.1%), and </span>trabeculectomy (5.8%).</p></div><div><h3>Conclusions</h3><p>Glaucoma following cataract surgery diagnosis in children in the IRIS Registry was associated with young age, aphakia, unilateral cataract, and Black race. Glaucoma drainage device surgery was the preferred surgical treatment, consistent with the World Glaucoma Association 2013 consensus recommendations for GFCS management.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":19519,"journal":{"name":"Ophthalmology. 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VanderVeen MD , Isdin Oke MD\",\"doi\":\"10.1016/j.ogla.2023.08.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>To compare demographic and clinical factors associated with glaucoma following cataract surgery<span><span> (GFCS) and glaucoma surgery rates between infants, toddlers, and older children using a large, </span>ophthalmic registry.</span></p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Participants</h3><p>Patients in the IRIS® Registry (Intelligent Research in Sight) who underwent cataract surgery at ≤ 17 years old and between January 1, 2013 and December 31, 2020.</p></div><div><h3>Methods</h3><p><span>Glaucoma diagnosis and procedural codes were extracted from the electronic health records of practices participating in the IRIS Registry. Children with glaucoma diagnosis or surgery before cataract removal were excluded. The Kaplan–Meier estimator was used to determine the cumulative probability of GFCS diagnosis and glaucoma surgery after cataract surgery. Multivariable </span>Cox regression was used to identify factors associated with GFCS and glaucoma surgery.</p></div><div><h3>Main Outcome Measures</h3><p>Cumulative probability of glaucoma diagnosis and surgical intervention within 5 years after cataract surgery.</p></div><div><h3>Results</h3><p><span>The study included 6658 children (median age, 10.0 years; 46.2% female). The 5-year cumulative probability of GFCS was 7.1% (95% confidence interval [CI], 6.1%–8.1%) and glaucoma surgery was 2.6% (95% CI, 1.9%–3.2%). The 5-year cumulative probability of GFCS for children aged < 1 year was 22.3% (95% CI, 15.7%–28.4%). Risk factors for GFCS included aphakia (hazard ratio [HR], 2.63; 95% CI, 1.96–3.57), unilateral cataract (HR, 1.48; 95% CI, 1.12–1.96), and Black race (HR, 1.61; 95% CI, 1.12–2.32). The most common surgery was glaucoma drainage device insertion (32.6%), followed by angle surgery (23.3%), cyclophotocoagulation (15.1%), and </span>trabeculectomy (5.8%).</p></div><div><h3>Conclusions</h3><p>Glaucoma following cataract surgery diagnosis in children in the IRIS Registry was associated with young age, aphakia, unilateral cataract, and Black race. Glaucoma drainage device surgery was the preferred surgical treatment, consistent with the World Glaucoma Association 2013 consensus recommendations for GFCS management.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>\",\"PeriodicalId\":19519,\"journal\":{\"name\":\"Ophthalmology. 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Risk Factors for Glaucoma Diagnosis and Surgical Intervention following Pediatric Cataract Surgery in the IRIS® Registry
Purpose
To compare demographic and clinical factors associated with glaucoma following cataract surgery (GFCS) and glaucoma surgery rates between infants, toddlers, and older children using a large, ophthalmic registry.
Design
Retrospective cohort study.
Participants
Patients in the IRIS® Registry (Intelligent Research in Sight) who underwent cataract surgery at ≤ 17 years old and between January 1, 2013 and December 31, 2020.
Methods
Glaucoma diagnosis and procedural codes were extracted from the electronic health records of practices participating in the IRIS Registry. Children with glaucoma diagnosis or surgery before cataract removal were excluded. The Kaplan–Meier estimator was used to determine the cumulative probability of GFCS diagnosis and glaucoma surgery after cataract surgery. Multivariable Cox regression was used to identify factors associated with GFCS and glaucoma surgery.
Main Outcome Measures
Cumulative probability of glaucoma diagnosis and surgical intervention within 5 years after cataract surgery.
Results
The study included 6658 children (median age, 10.0 years; 46.2% female). The 5-year cumulative probability of GFCS was 7.1% (95% confidence interval [CI], 6.1%–8.1%) and glaucoma surgery was 2.6% (95% CI, 1.9%–3.2%). The 5-year cumulative probability of GFCS for children aged < 1 year was 22.3% (95% CI, 15.7%–28.4%). Risk factors for GFCS included aphakia (hazard ratio [HR], 2.63; 95% CI, 1.96–3.57), unilateral cataract (HR, 1.48; 95% CI, 1.12–1.96), and Black race (HR, 1.61; 95% CI, 1.12–2.32). The most common surgery was glaucoma drainage device insertion (32.6%), followed by angle surgery (23.3%), cyclophotocoagulation (15.1%), and trabeculectomy (5.8%).
Conclusions
Glaucoma following cataract surgery diagnosis in children in the IRIS Registry was associated with young age, aphakia, unilateral cataract, and Black race. Glaucoma drainage device surgery was the preferred surgical treatment, consistent with the World Glaucoma Association 2013 consensus recommendations for GFCS management.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.