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北京地区白内障手术患病率及术后视觉转归:北京眼病研究

Prevalence of cataract surgery and postoperative visual outcome in Greater Beijing: the Beijing Eye Study.

作者信息

Liu Bin, Xu Liang, Wang Ya Xing, Jonas Jost B

机构信息

Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing, China.

出版信息

Ophthalmology. 2009 Jul;116(7):1322-31. doi: 10.1016/j.ophtha.2009.01.030. Epub 2009 Jun 4.

DOI:10.1016/j.ophtha.2009.01.030
PMID:19500855
Abstract

PURPOSE

To determine the prevalence of cataract surgery and the postoperative visual outcome in the adult Chinese population living in rural and urban regions of Greater Beijing.

DESIGN

Population-based study.

PARTICIPANTS

The Beijing Eye Study 2006 included 3251 subjects (73.3%) (aged 45+ years) of 4439 subjects who participated in the 2001 survey and returned for reexamination.

METHODS

The prevalence of surgical pseudophakia/aphakia was assessed, and postoperative visual acuity and reasons for decreased postoperative vision were examined. Visual impairment was defined by a presenting visual acuity (PVA) <6/18 or a best-corrected visual acuity (BCVA) <6/18.

MAIN OUTCOME MEASURES

Prevalence of cataract surgery, lens status, and causes of visual impairment.

RESULTS

Of the 3215 (98.9% of 3251) subjects for whom data on the lens status were available, 92 (41 male, 133 eyes) had undergone cataract surgery in 1 or both eyes (prevalence rate, 2.86%; 95% confidence interval [CI], 2.28-3.44). In multivariate analysis, this rate was statistically associated with higher age (P<0.001), presence of angle-closure glaucoma (P = 0.02), and higher level of hemorrhagic retinopathy (P<0.001). The prevalence of postoperative visual impairment was 27/133 (20.3%), as defined by a PVA <6/18, and 14/133 or 10.5%, as defined by a BCVA <6/18. Aphakia (odds ratio [OR], 6.71; P = 0.02) and rural residence (OR, 4.05; P = 0.01) were significantly associated with postoperative visual impairment. The most common causes of postoperative visual impairment were uncorrected refractive error followed by hemorrhagic retinopathy and posterior capsule opacification. By comparing 2001 with 2006, the rate of cataract surgery increased, and the rate of postoperative visual impairment decreased significantly (P = 0.049).

CONCLUSIONS

In the adult population of Greater Beijing, approximately 3% of the population aged 45+ years underwent cataract surgery, the prevalence of which was associated with age, angle-closure glaucoma, and hemorrhagic retinopathy. One of 10 subjects who underwent cataract surgery had a BCVA visual of less than 6/18, and 1 of 5 subjects had a PVA of less than 6/18. Low postoperative visual acuity was associated with rural region, undercorrection of refractive error, and hemorrhagic retinopathy.

摘要

目的

确定居住在北京城乡地区的成年中国人群中白内障手术的患病率及术后视力结果。

设计

基于人群的研究。

参与者

2006年北京眼病研究纳入了参与2001年调查并返回接受复查的4439名受试者中的3251名(73.3%)(年龄≥45岁)。

方法

评估手术性人工晶状体眼/无晶状体眼的患病率,并检查术后视力及术后视力下降的原因。视力损害定义为就诊视力(PVA)<6/18或最佳矫正视力(BCVA)<6/18。

主要观察指标

白内障手术的患病率、晶状体状态及视力损害的原因。

结果

在3215名(占3251名的98.9%)有晶状体状态数据的受试者中,92名(41名男性,133只眼)一只或两只眼睛接受了白内障手术(患病率为2.86%;95%可信区间[CI],2.28 - 3.44)。多因素分析中,该患病率与年龄较大(P<0.001)、闭角型青光眼(P = 0.02)及视网膜出血性病变程度较高(P<0.001)存在统计学关联。按照PVA<6/18定义,术后视力损害的患病率为27/133(20.3%),按照BCVA<6/18定义为14/133或10.5%。无晶状体眼(比值比[OR],6.71;P = 0.02)及农村居住地区(OR,4.05;P = 0.01)与术后视力损害显著相关。术后视力损害最常见的原因是屈光不正未矫正,其次是视网膜出血性病变和后囊膜混浊。通过比较2001年和2006年的数据,白内障手术率上升,术后视力损害率显著下降(P = 0.049)。

结论

在北京成年人群中,年龄≥45岁的人群中约3%接受了白内障手术,其患病率与年龄、闭角型青光眼及视网膜出血性病变有关。接受白内障手术的受试者中,每10人中有1人BCVA视力低于6/18,每5人中有1人PVA低于6/18。术后低视力与农村地区、屈光不正矫正不足及视网膜出血性病变有关。

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