Department of Ophthalmology, University of Bonn, Bonn, Germany.
PLoS One. 2012;7(8):e44268. doi: 10.1371/journal.pone.0044268. Epub 2012 Aug 31.
To explore the hypothesis that sight restoring cataract surgery provided to impoverished rural communities will improve not only visual acuity and vision-related quality of life (VRQoL) but also poverty and social status.
Participants were recruited at outreach camps in Tamil Nadu, South India, and underwent free routine manual small incision cataract surgery (SICS) with intra-ocular lens (IOL) implantation, and were followed up one year later. Poverty was measured as monthly household income, being engaged in income generating activities and number of working household members. Social status was measured as rates of re-marriage amongst widowed participants. VRQoL was measured using the IND-VFQ-33. Associations were explored using logistic regression (SPSS 19).
Of the 294 participants, mean age ± standard deviation (SD) 60 ± 8 years, 54% men, only 11% remained vision impaired at follow up (67% at baseline; p<0.001). At one year, more participants were engaged in income generating activities (44.7% to 77.7%; p<0.001) and the proportion of households with a monthly income <1000 Rps. decreased from 50.5% to 20.5% (p<0.05). Overall VRQoL improved (p<0.001). Participants who had successful cataract surgery were less likely to remain in the lower categories of monthly household income (OR 0.05-0.22; p<0.02) and more likely to be engaged in income earning activities one year after surgery (OR 3.28; p = 0.006). Participants widowed at baseline who had successful cataract surgery were less likely to remain widowed at one year (OR 0.02; p = 0.008).
These findings indicate the broad positive impact of sight restoring cataract surgery on the recipients' as well as their families' lives. Providing free high quality cataract surgery to marginalized rural communities will not only alleviate avoidable blindness but also - to some extent - poverty in the long run.
探索这样一种假说，即向贫困农村社区提供视力恢复性白内障手术不仅可以提高视力和与视觉相关的生活质量（VRQoL），而且还可以改善贫困状况和社会地位。
在印度南部泰米尔纳德邦的外展营地招募参与者，并为他们进行免费的常规手动小切口白内障手术（SICS）和人工晶状体（IOL）植入，然后在一年后进行随访。贫困程度通过家庭月收入、参与创收活动的情况以及有工作的家庭成员人数来衡量。社会地位通过丧偶参与者的再婚率来衡量。使用印度视觉功能调查问卷 33 项（IND-VFQ-33）来衡量 VRQoL。使用逻辑回归（SPSS 19）来探讨相关性。
在 294 名参与者中，平均年龄±标准差（SD）为 60±8 岁，54%为男性，只有 11%在随访时仍存在视力障碍（基线时为 67%；p<0.001）。一年后，更多的参与者参与了创收活动（44.7%至 77.7%；p<0.001），每月收入<1000 卢比的家庭比例从 50.5%降至 20.5%（p<0.05）。总体 VRQoL 有所提高（p<0.001）。白内障手术成功的参与者不太可能继续处于家庭月收入较低的类别（OR 0.05-0.22；p<0.02），并且在手术后一年更有可能从事创收活动（OR 3.28；p = 0.006）。基线时丧偶且白内障手术成功的参与者在一年后再婚的可能性较低（OR 0.02；p = 0.008）。
这些发现表明，视力恢复性白内障手术对接受手术者及其家庭生活产生了广泛的积极影响。向边缘化农村社区提供免费高质量的白内障手术不仅可以消除可避免的失明，而且从长远来看，在一定程度上还可以减轻贫困。
