在白内障手术中是否有安全的血糖值?
Zain S Hussain1, Ahmed F Shakarchi1, Muhammad Z Chauhan1
1Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
American journal of ophthalmology
|May 5, 2025
概括
糖尿病患者的白内障手术没有增加术后内炎或严重的系统性事件的风险,无论血红蛋白A1c (HbA1c) 水平如何. 这些发现支持对糖尿病患者手术适应性进行个性化风险评估.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 健康 结果 研究 研究 结果
背景情况:
- 糖尿病是一种普遍影响视力的疾病,白内障形成是常见的并发症.
- 糖尿病患者血红蛋白A1c (HbA1c) 水平升高可能会影响手术结果.
- 选择性手术的安全性,如白内障手术在糖尿病人群中,需要仔细评估.
研究的目的:
- 为了研究白内障手术和30天后术后内炎 (POE) 之间的关联,在患有不同HbA1c水平的糖尿病患者中.
- 评估白内障手术后发生严重系统性不良事件的风险,对糖尿病患者进行HbA1c分层.
- 为了比较接受白内障手术的糖尿病患者的结果与非糖尿病对照和未接受手术的糖尿病对照.
主要方法:
- 一个回顾性,纵向的队列研究,利用全球联合电子健康记录数据库.
- 包括患有1型或2型糖尿病的成年患者 (≥18岁),他们接受了发酵性白内障手术.
- 分析POE的30天发病率和严重的系统性不良事件 (死亡率,中风,主要心血管事件),使用Cox比例危险模型计算的危险比率.
主要成果:
- 与非糖尿病对照组相比,在不同HbA1c水平之间没有观察到30天POE风险的显著差异.
- 对POE的危险比率在0.62 (HbA1c <7%) 到2.85 (HbA1c >11.3%) 之间,没有统计学意义上的上升.
- 与对照组相比,严重系统性不良事件的30天发病率在HbA1c水平之间没有显著差异,90天后的发现类似.
结论:
- 糖尿病患者的白内障手术似乎不会增加术后内炎或严重的全身不良事件的风险,在HbA1c水平的范围内.
- 仅仅手术前的HbA1c水平不应该是推迟白内障手术的禁忌.
- 个性化风险评估对于在接受白内障手术的糖尿病患者中确定手术候选人是至关重要的.
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