Postoperative Endophthalmitis After Cataract Surgery

摘要

Age-related cataracts affect more than 22 million Americans, and that number may rise to 30 million by 2020. In the United States, almost 20% of older adults aged 65 to lA years have cataracts that interfere with their vision. While cataract surgery rates are rising in all age groups between 50 and 90 years, it appears that the greatest increase is in those aged 70 to 80 years, owing in part to aging baby boomers who are working longer, desiring to be more active, and placing more demands on their vision. With regard to the U.S. Medicare population, cataract extraction is the most commonly performed surgical procedure, and both the annual total volume and age-adjusted rates of cataract surgery have increased substantially since the 1980s. Furthermore, it is estimated that at least 80% of cataract surgery in this country is'performed on Medicare beneficiaries. Many individuals have no risk factors other than age; however, some cataracts are congenital and are associated with numerous syndromes and diseases, such as diabetes. Cataracts usually develop slowly over a period of years and are the leading cause of blindness worldwide. Pharmacists can educate patients regarding the modifiable risk factors for cataracts, which include taking systemic corticosteroids; poor control of blood glucose; the use of alcohol and tobacco; and chronic ultraviolet light exposure (TABLE l). A diet high in vitamin C, vitamin A, and carotenoids (i.e., contained in vegetables such as spinach and kale) may protect against cataracts, and ophthalmologists often recommend ultraviolet-coated eyeglasses or sunglasses as a preventive measure.