Author:
Shen Wei,Cun Qing,Zhong Hua,Pan Chen-Wei,Li Jun,Chen Qin
Abstract
Abstract
Background
As a part of the Yunnan Minority Eye Studies, the purpose of this study was to determine the prevalence, barriers and visual acuity outcomes of cataract surgery in a multiethnic adult population in rural areas of southwestern China.
Methods
A population-based cross-sectional survey was conducted with participants of Bai, Yi, and Han ethnicity aged ≥50 years in Yunnan. A detailed eye examination was performed. Information on the date, setting, type, and complications of cataract surgery were recorded in the examination of cataract-operated eyes.
Results
Of 6546 subjects (2133 Bai ethnicity, 2208 Yi ethnicity and 2205 Han ethnicity), the prevalence of cataract surgery was 6.0%, with 4.6% in Bai, 7.0% in Yi, and 6.4% in Han ethnicity. Cataract Surgical coverage (CSC) among those with presenting visual acuity (PVA) < 20/200 in both eyes because of cataract was 53.3%, with 52.8% in Bai, 64.4% in Yi, and 45.3% in Han ethnicity. CSC was associated with Yi ethnicity, younger age, and higher education level, while unoperated cataract was associated with Han ethnicity, older age, and illiterate. The main barrier to cataract surgery was lack of awareness and knowledge, cost, and fear. Among the 525 cataract-operated eyes, PVA and best-corrected visual acuity (BCVA) of 20/63 or better was 44.5 and 67.2%, respectively, with 48.1 and 65.9% in Bai, 47.8 and 75.4% in Yi, 39.1 and 59.9% in Han ethnicity. Han ethnicity, aphakia, earlier year of surgery, lower-level surgical hospital and illiterate were associated with postoperative visual impairment defined by PVA, while Han ethnicity, aphakia, and illiterate were associated with that defined by BCVA. The principal causes of postoperative visual impairment were retinal disorders (26.8%), posterior capsule opacification (25.1%), refractive error(22.7%), and glaucoma (9.3%).
Conclusions
Han ethnicity had a lower CSC and relatively poor visual outcomes compared with ethnic minorities. Further effective effort to remove barriers and provide sight restoration is warranted.
Funder
National Natural Science Foundation of China
Yunnan Province Medical and Health Internal Research Institution Project
the Association Foundation Program of Yunnan Provincial Science and Technology Department and Kunming Medical University
Provincial Innovation Team for Cataract and Ocular Fundus Disease, the Second People’s Hospital of Yunnan Province
Expert Workstation of Yao Ke
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference32 articles.
1. World Health Organization. Global data on visual impairments 2010, Available: http://www.who.int/blindness/GLOBALDATAFINALforweb.pdf. Accessed 25 Dec 2014.
2. Shen W, Yang Y, Yu M, Li J, Wei T, Li X, et al. Prevalence and outcomes of cataract surgery in adult rural Chinese populations of the Bai nationality in Dali: the Yunnan minority eye study. PLoS One. 2013;8(4):e60236. https://doi.org/10.1371/journal.pone.0060236.
3. Sapkota YD, Pokharel GP, Dulal S, Byanju RN, Maharjan IM. Barriers to up take cataract surgery in Gandaki Zone, Nepal. Kathmandu Univ Med J (KUMJ). 2004;2:103–12.
4. Athanasiov PA, Edussuriya K, Senaratne T, Sennanayake S, Selva D, Casson RJ. Cataract in Central Sri Lanka: cataract surgical coverage and self-reported barriers to cataract surgery. Clin Exp Ophthalmol. 2009;37:780–4.
5. Jadoon Z, Shah SP, Bourne R, Dineen B, Khan MA, Gilbert CE, et al. Cataract prevalence, cataract surgical coverage and barriers to uptake of cataract surgical services in Pakistan: the Pakistan National Blindness and visual impairment survey. Br J Ophthalmol. 2007;91:1269–73.