Briesen Sebastian, Roberts Helen, Ilako Dunera, Karimurio Jefitha, Courtright Paul
Kwale District Eye Centre, Mombasa, Kenya.
Ophthalmic Epidemiol. 2010 Jan-Feb;17(1):41-9. doi: 10.3109/09286580903447938.
To determine possible differences in visual acuity, socio-demographic factors and vision-related Quality of Life (QoL) between people accepting and people refusing sponsored cataract surgery.
Three hundred and fifty seven local residents with visually impairing cataract, presenting at screening sites in Kwale District, Kenya were clinically assessed and interviewed. The World Health Organization (WHO) QoL-questionnaire WHO/Prevention of Blindness and Deafness Visual Functioning Questionnaire 20 (PBD-VFQ20) was used to determine the vision-related QoL. A standardized questionnaire asked for socio-demographic data and prior cataract surgery in one eye. After interview, patients were offered free surgery. Primary outcome was the mean QoL-score between acceptors and non-acceptors. Secondary outcomes were visual acuity and socio-demographic factors and their contribution to QoL-scores and the decision on acceptance or refusal.
Fifty nine people (16.5%) refused and 298 accepted cataract surgery. Vision-related QoL was poorer in people accepting than in those refusing (mean score 51.54 and 43.12 respectively). People with poor visual acuity were only slightly more likely to accept surgery than people with better vision; the strongest predictors of acceptance were the QoL-score and gender. Men were twice as likely to accept compared to women. Of people who accepted surgery, 73.8% had best eye vision of 20/200 or better.
In this population, visual acuity was of limited use to predict a person's decision to accept or refuse cataract surgery. QoL-scores provide further insight into which individuals will agree to surgery and it might be useful to adapt the QoL-questions for field use. Gender inequities remain a matter of concern with men being more likely to get sight-restoring surgery.
确定接受和拒绝资助性白内障手术的人群在视力、社会人口学因素以及与视力相关的生活质量（QoL）方面可能存在的差异。
对肯尼亚夸莱区筛查点的357名患有视力损害性白内障的当地居民进行了临床评估和访谈。使用世界卫生组织（WHO）生活质量问卷WHO/防盲治聋视觉功能问卷20（PBD-VFQ20）来确定与视力相关的生活质量。一份标准化问卷询问了社会人口学数据和单眼先前的白内障手术情况。访谈后，为患者提供免费手术。主要结局是接受者和非接受者之间的平均生活质量得分。次要结局是视力和社会人口学因素及其对生活质量得分的贡献以及接受或拒绝手术的决定。
59人（16.5%）拒绝，298人接受了白内障手术。接受手术者的视力相关生活质量比拒绝者差（平均得分分别为51.54和43.12）。视力差的人接受手术的可能性仅略高于视力较好的人；接受手术的最强预测因素是生活质量得分和性别。男性接受手术的可能性是女性的两倍。接受手术的人中，73.8%的最佳眼视力为20/200或更好。
在该人群中，视力对预测一个人接受或拒绝白内障手术的决定作用有限。生活质量得分能进一步了解哪些个体将同意手术，并且调整生活质量问题以用于实地可能会有所帮助。性别不平等仍然是一个令人担忧的问题，男性更有可能接受恢复视力的手术。
