Lewallen S, Mousa A, Bassett K, Courtright P
Kilimanjaro Centre for Community Ophthalmology, Tumaini University/KCM College, Moshi, Tanzania.
Br J Ophthalmol. 2009 Mar;93(3):295-8. doi: 10.1136/bjo.2008.140301. Epub 2008 Dec 17.
Cataract remains the leading cause of global blindness. Evidence from population-based surveys, carried out up to 2000, and the launch of the VISION 2020 initiative to address avoidable blindness showed that women in low- and middle-income countries had a lower cataract surgical coverage (CSC) than men.
A systematic review identified population-based surveys reporting CSC in low- and middle-income countries published since 2000. Researchers extracted data on sex-specific CSC rates and estimated the overall CSC differences using meta-analyses.
Among the 23 surveys selected for this review, 21 showed higher CSC among men. The Peto odds ratio revealed that men were 1.71 times (95% CI 1.48 to 1.97) more likely to have cataract surgery than women. The risk difference in the rates of surgery varied from -0.025 to 0.276, and the combined average was 0.116 (95% CI 0.082 to 0.149).
Gender inequity in use of cataract surgical services persists in the low- and middle-income countries. It is estimated in this study that blindness and severe visual impairment from cataract could be reduced by around 11% in the low- and middle-income countries if women were to receive cataract surgery at the same rate as men. Additional effort globally is needed to ensure that women receive the benefits of cataract surgery at the same rate as men.
白内障仍然是全球失明的主要原因。基于2000年以前进行的人群调查的证据，以及为解决可避免失明问题而发起的“视觉2020”倡议表明，低收入和中等收入国家的女性白内障手术覆盖率（CSC）低于男性。
一项系统综述确定了自2000年以来发表的报告低收入和中等收入国家CSC的基于人群的调查。研究人员提取了按性别划分的CSC率数据，并使用荟萃分析估计了总体CSC差异。
在本次综述所选的23项调查中，21项显示男性的CSC较高。Peto比值比显示，男性进行白内障手术的可能性是女性的1.71倍（95%置信区间为1.48至1.97）。手术率的风险差异从-0.025到0.276不等，综合平均值为0.116（95%置信区间为0.082至0.149）。
低收入和中等收入国家在白内障手术服务使用方面的性别不平等现象仍然存在。本研究估计，如果女性接受白内障手术的比例与男性相同，低收入和中等收入国家因白内障导致的失明和严重视力损害可减少约11%。全球需要做出更多努力，以确保女性与男性以相同的比例受益于白内障手术。
