大理白族农村成人白内障手术患病率及结局：云南少数民族眼病研究。
Prevalence and outcomes of cataract surgery in adult rural Chinese populations of the Bai nationality in Dali: the Yunnan minority eye study.
机构信息
The First Affiliated Hospital of Kunming Medical University, Kunming, China ; Yunnan Red Cross Hospital, Kunming, China.
出版信息
PLoS One. 2013;8(4):e60236. doi: 10.1371/journal.pone.0060236. Epub 2013 Apr 5.
PURPOSE
To investigate the prevalence and visual acuity (VA) outcomes of cataract surgery in adults of the Bai Nationality populations in rural China.
METHODS
We conducted a population-based cross-sectional survey (from randomly selected block groups) of Chinese Bai Nationality aged ≥50 years in southwestern China. Presenting visual acuity (PVA), best corrected visual acuity (BCVA) were recorded and a detailed eye examination was carried out. For all aphakic and pseudophakic subjects identified, information on the date, setting, type, and complications of cataract surgery were recorded. In eyes with VA <20/63, the principal cause of visual impairment was identified.
RESULTS
Of 2133 (77.8% of 2742) subjects, 99 people (129 eyes) had undergone cataract surgery. The prevalence of cataract surgery was 4.6%. Surgical coverage among those with PVA <20/200 in both eyes because of cataract was 52.8%. Unoperated cataract was associated with older age. The main barrier to cataract surgery was lack of awareness and knowledge, cost, and fear. Among the 129 cataract-operated eyes, 22.5% had PVA of ≥20/32, 25.6% had PVA of 20/40 to 20/63, 23.3% had PVA <20/63 to 20/200, and 28.7% had PVA<20/200. With BCVA, the percentages were 42.6%, 23.3%, 10.9%, and 23.3%, respectively. Aphakia (odds ratio [OR], 8.49; P<0.001) and no education (OR, 10.18; P = 0.001) or less education (OR, 6.49; P = 0.014) were significantly associated with postoperative visual impairment defined by PVA, while aphakia (OR, 8.49; P<0.001) and female gender (OR, 4.19; P = 0.004) were significantly associated with postoperative visual impairment by BCVA. The main causes of postoperative visual impairment were refractive error, retinal disorders and glaucoma.
CONCLUSIONS
Half of those with bilateral visual impairment or blindness because of cataract remain in need of cataract surgery in Bai population. Surgical uptake and visual outcomes should be further improved in the future.
目的
调查中国农村白族成年人白内障手术的患病率和视力结果。
方法
我们在中国西南部进行了一项基于人群的横断面调查（从随机选择的街区小组中进行），调查对象为年龄≥50 岁的中国白族。记录了当前视力（PVA）和最佳矫正视力（BCVA），并进行了详细的眼部检查。对于所有确定的无晶状体和假晶状体患者，记录了白内障手术的日期、地点、类型和并发症信息。在 VA<20/63 的眼中，确定了视力损害的主要原因。
结果
在 2133 名（2742 名的 77.8%）受试者中，有 99 人（129 只眼）接受了白内障手术。白内障手术的患病率为 4.6%。双眼因白内障导致 PVA<20/200 的人群中，手术覆盖率为 52.8%。未手术的白内障与年龄较大有关。白内障手术的主要障碍是缺乏意识和知识、费用和恐惧。在 129 只白内障手术眼中，22.5%的 PVA≥20/32，25.6%的 PVA 为 20/40 至 20/63，23.3%的 PVA<20/63 至 20/200，28.7%的 PVA<20/200。用 BCVA 测量，相应的百分比分别为 42.6%、23.3%、10.9%和 23.3%。无晶状体（优势比 [OR]，8.49；P<0.001）和未受教育（OR，10.18；P=0.001）或受教育程度较低（OR，6.49；P=0.014）与 PVA 定义的术后视力损害显著相关，而无晶状体（OR，8.49；P<0.001）和女性（OR，4.19；P=0.004）与 BCVA 定义的术后视力损害显著相关。术后视力损害的主要原因是屈光不正、视网膜疾病和青光眼。
结论
在白族人群中，有一半因白内障导致双眼视力障碍或失明的人仍需要白内障手术。未来应进一步提高手术接受率和视力结果。
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