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

• 批准号: 10391435
• 负责人: Sapna S Gangaputra
• 金额: $ 20.21万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10391435
• 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; Modeling; 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 defect; Structure; 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

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.”

项目摘要 葡萄膜炎与视觉障碍和较高的结果相关 眼内手术 - 例如白内障手术或青光眼手术。建议的指南 防止视觉障碍并实现成功的手术结果包括静止 术前至少3个月的炎症和严格的炎症控制 但是，定期期，但是有限的证据有限 接受葡萄膜性白内障手术和葡萄糖瘤的患者的现实结局 外科手术。针对眼部疾病的全身免疫抑制疗法（现场）队列研究是一种 葡萄膜炎患者的丰富数据库（17,907名不同的患者跟踪了169,194次访问） 有关炎症状况，接受药物，手术和其他的详细信息 结果。该数据库包括250多名18岁以下的儿童 白内障手术和100多名在一个野外接受葡萄糖瘤手术的儿童 关于小儿葡萄象白内障和小儿葡萄糖瘤的非常稀疏的文献。患者 在前6个月中，他有切开性白内障或青光眼手术，至少进行一次访问 手术和至少两次术后8周的术后访问包括 分析。这笔赠款的结果可以（1）指导临床医生和患者回复：最佳 在围手术期间对患者的管理，以达到最佳的视力和 眼内压力控制，（2）探索随后的眼内手术的入射 特别是在儿童中，这会影响手术计划，（3）指导 - 患者的手术管理，以防止眼内感染，然后 最佳视觉结果。是否要离开孩子Aphak的问题以及是否 小梁切除术或管子分流与长期的眼内压控制有关，因此 保留视觉功能，将通过此分析具有基于证据的指南。 这些目标是对国家眼睛研究所的战略计划和目标的反应 支持针对盲目眼病和视力保存的应用临床研究， 特别是目标“建立葡萄膜炎的原因和病因和改进方法 诊断，治疗和预防。”

项目成果

Incidence of and Risk Factors for Cataract in Anterior Uveitis.

前葡萄膜炎白内障的发病率和危险因素。

• DOI: 10.1016/j.ajo.2023.06.021
• 发表时间: 2023
• 期刊: American journal of ophthalmology
• 影响因子: 4.2
• 作者: Papaliodis,GeorgeN;Rosner,BernardA;Dreger,KurtA;Fitzgerald,TonettaD;Artornsombudh,Pichaporn;Kothari,Srishti;Gangaputra,SapnaS;Levy-Clarke,GraceA;Nussenblatt,RobertB;Rosenbaum,JamesT;Sen,HNida;Suhler,EricB;Thorne,Jennifer
• 通讯作者: Thorne,Jennifer