Athanasiov Paul A, Casson Robert J, Newland Henry S, Shein Win K, Muecke James S, Selva Dinesh, Aung Than
Department of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Clin Exp Ophthalmol. 2008 Aug;36(6):521-5. doi: 10.1111/j.1442-9071.2008.01829.x.
The aim of this study is to determine the cataract surgical coverage and investigate the barriers to cataract surgery as reported by those with cataract-induced visual impairment in rural Myanmar.
A cross-sectional, population-based survey of inhabitants 40 years of age and over from villages in the Meiktila District (central Myanmar); 2481 eligible participants were identified and 2076 participated. Data recording included corrected visual acuity, dilated slit lamp examination and stereoscopic fundus examination. Lens opacity was graded using the Lens Opacities Classification System III. Participants with cataract-induced visual impairment (acuity < 6/18 in better eye) were also invited to respond to a verbal questionnaire about barriers to cataract surgery.
Cataract surgical coverage for visual acuity cut-offs of <6/18, <6/60 and <3/60 was 9.74%, 20.11% and 22.3%, respectively, for people and 4.18%, 9.39% and 13.47%, respectively, for eyes. Cataract surgical coverage was higher for men than women, but gender was not associated with refusal of services. Of the 239 who responded to the extra questionnaire, 216 were blind or had low vision owing to cataract. Three quarters refused referral for surgery: cost and fear of surgery were the most frequently reported barriers.
Cost plays a large role in the burden of cataract in this region. Implementation of educational programmes, reforms to local health service and subsidization of ophthalmic care may improve the uptake of cataract surgery.
本研究旨在确定缅甸农村地区白内障手术的覆盖范围，并调查白内障致视力损害患者报告的白内障手术障碍。
对密铁拉地区（缅甸中部）各村40岁及以上居民进行基于人群的横断面调查；确定了2481名符合条件的参与者，其中2076人参与。数据记录包括矫正视力、散瞳裂隙灯检查和立体眼底检查。使用晶状体混浊分类系统III对晶状体混浊进行分级。还邀请了白内障致视力损害（较好眼视力<6/18）的参与者回答一份关于白内障手术障碍的口头问卷。
视力截止值<6/18、<6/60和<3/60时，人群的白内障手术覆盖率分别为9.74%、20.11%和22.3%，眼睛的白内障手术覆盖率分别为4.18%、9.39%和13.47%。男性的白内障手术覆盖率高于女性，但性别与拒绝服务无关。在回答额外问卷的239人中，216人因白内障失明或视力低下。四分之三的人拒绝转诊手术：费用和对手术的恐惧是最常报告的障碍。
费用在该地区白内障负担中起很大作用。实施教育项目、改革当地卫生服务以及补贴眼科护理可能会提高白内障手术的接受率。
