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Nanchang, China

Zhao J.,Peking Union Medical College | Ellwein L.B.,U.S. National Institutes of Health | Cui H.,Harbin Medical University | Ge J.,Sun Yat Sen University | And 7 more authors.
Ophthalmology | Year: 2010

Purpose: To investigate the prevalence and visual acuity (VA) outcomes of cataract surgery in rural populations throughout China. Design: Population-based, cross-sectional study. Participants: Forty-five thousand seven hundred forty-seven adults 50 years of age and older. Methods: Geographically defined cluster sampling was used in randomly selecting a cross-section of residents from a representative rural county within each of 9 provinces in mainland China. Participants underwent VA measurements, refraction, and a slit-lamp examination at local examination sites; those with previous cataract surgery were queried as to the year and type of surgical facility. Surgical procedure and evidence of surgery complications were noted during the examination. The principal cause of visual impairment was identified for eyes with VA of 20/40 or worse. Main Outcome Measures: Cataract surgery procedure, presenting and best-corrected distance VA, and causes of visual impairment. Results: Of 50 395 enumerated eligible persons, 45 747 (90.8%) were examined and tested for VA. The overall prevalence of cataract surgery was 2.09%. Surgical coverage among those with VA worse than 20/200 in both eyes because of cataract was 35.7%. Unoperated cataract was associated with older age, female gender, lack of education, and geographic area (province). Among the 1174 cataract-operated eyes, 31.1% had presenting VA of 20/32 or better, 15.4% had presenting VA of 20/40 to 20/63, 30.0% had presenting VA worse than 20/63 to 20/200, and 23.5% had presenting VA worse than 20/200. With best correction, the percentages were 57.6%, 6.2%, 18.5%, and 17.7%, respectively. Posterior capsule opacification, refractive error, and retinal disorders were the main causes in cataract-operated eyes with VA worse than 20/63. Conclusions: Two thirds of those with bilateral visual impairment or blindness because of cataract remain in need of sight-restoring surgery. Posterior capsule opacification and refractive error, both readily amenable to treatment, were common in cataract-operated eyes. Sustained government efforts to provide access to affordable modern cataract surgery with a greater emphasis on postoperative follow-up and the quality of VA outcomes are needed. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2010 American Academy of Ophthalmology.

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