Outcomes of uveitic cataract and uveitic glaucoma surgery

葡萄膜炎性白内障和葡萄膜炎性青光眼手术的结果

基本信息

批准号：
10193155
负责人：
Sapna S Gangaputra
金额：
$ 28.61万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-01 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10193155
关键词：
Adult Age Anterior Anterior uveitis Blindness Cataract Cataract Extraction Child Childhood Clinical Research Cohort Studies Cornea Data Data Analyses Data Set Databases Diagnosis Disease Disease remission Electronic Health Record Etiology Event Eye Eye diseases Failure Funding Glaucoma Goals Grant Guidelines Incidence Inflammation Inflammatory Intermediate Uveitis International Classification of Disease Codes Light Literature Methods National Eye Institute Operative Surgical Procedures Ophthalmologist Outcome Panuveitis Patient-Focused Outcomes Patients Perception Perioperative Persons Pharmaceutical Preparations Physiologic Intraocular Pressure Postoperative Period Predictive Factor Prevention Prognosis Randomized Clinical Trials Repeat Surgery Research Resources Risk Risk Factors Shunt Device Specialist Strategic Planning Structural Models Structural defect Surgical incisions Therapeutic immunosuppression Time Trabeculectomy Tube United States United States National Institutes of Health Update Uveitis Vision Visit Visual Visual Acuity Visual impairment aggressive therapy analytical method base capsule cohort disability evidence based guidelines eye preservation glaucoma surgery improved pediatric patients preservation prevent surgery outcome

项目摘要

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.”

项目概要葡萄膜炎与视力障碍以及术后不良结果的发生率较高有关眼内手术——例如白内障手术或青光眼手术。预防视力障碍并实现成功的手术结果，包括静止术前炎症至少3个月，术中严格控制炎症围手术期，然而，作为实践依据的证据有限接受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果眼部疾病的全身免疫抑制治疗 (SITE) 队列研究是一项丰富的葡萄膜炎患者数据库（17,907 名不同患者随访超过 169,194 次访问）有关炎症状态、接受的药物、手术和其他的详细信息该数据库包含超过 250 名 18 岁以下患有葡萄膜炎的儿童。白内障手术和 100 多名接受葡萄膜炎性青光眼手术的儿童关于儿童葡萄膜性白内障和儿童葡萄膜性青光眼患者的文献非常少。接受过切开式白内障或青光眼手术且在手术前 6 个月内至少就诊过一次的人手术和术后 8 周后至少两次术后就诊均包含在这项资助的结果可以（1）指导精英和患者：最佳选择。在围手术期对患者进行管理，以达到尽可能最佳的视力和眼压控制，（2）探讨后续眼内手术的发生率，尤其是在儿童中，这将影响手术计划并 (3) 指导围手术期对患者进行手术管理以预防眼内炎症和随后的治疗是否让孩子患有无晶状体眼以及是否有最佳视觉效果的问题。小梁切除术或管分流术与长期眼压控制相关，因此保护视觉功能，将通过此分析获得基于证据的指南。这些目标响应国家眼科研究所的战略计划和目标，支持有关致盲眼病和保护视力的应用临床研究，特别是目标“确定葡萄膜炎的原因和病因并改进其治疗方法” 诊断、治疗和预防。”