Xiao Baixiang, Guan Chunhong, He Yaling, Le Mesurier Richard, Müller Andreas, Limburg Hans, Iezze Beatrice
The Affiliated Eye Hospital of Nanchang University , Nanchang City , China .
Ophthalmic Epidemiol. 2013 Oct;20(5):288-93. doi: 10.3109/09286586.2013.794901. Epub 2013 Jul 2.
To assess cataract surgical outcomes during the Jiangxi Provincial Government's "Brightness and Smile Initiative" (BSI) in South East China during May 2009 to July 2010.
This cross sectional combined with retrospective study included 1157 cataract surgical patients (1254 eyes) recruited from six counties in Jiangxi during the initiative. Patient information before surgery and at discharge was obtained from hospitals' case records. Patient follow-up eye examinations were conducted during field visits in the autumn of 2010. Fifteen months after the initiative started, study subjects were examined by provincial ophthalmologists using a Snellen visual chart, portable slit lamp, torch and ophthalmoscope. The World Health Organization (WHO) cataract surgical outcome monitoring tally sheet and the outcome categories good (visual acuity, VA, ≥ 0.3 (6/18)), borderline (VA <0.3 but ≥ 0.1 (6/60)) and poor (VA < 0.1) were used for data collection and analysis.
A total of 99.7% of operated patients had intraocular lenses implanted. The percentage of eyes with good outcomes (presenting VA) at follow-up was low (49.6%), while the borderline and poor outcome rates were high (34.1% and 16.3%, respectively), in comparison to WHO recommendations. There was a significant outcome difference at follow-up (p < 0.01) between eyes operated by county surgeons trained by an International Non-Government Organization and those operated on by other visiting surgeons.
This study documented a low rate of good cataract surgical outcomes from the BSI in Jiangxi. The quality of cataract surgery should be improved further in the province.
评估2009年5月至2010年7月在中国东南部江西省开展的省政府“光明微笑工程”（BSI）期间白内障手术的效果。
这项横断面结合回顾性研究纳入了该工程期间从江西省6个县招募的1157例白内障手术患者（1254只眼）。术前和出院时的患者信息从医院病历中获取。2010年秋季实地走访期间对患者进行了随访眼部检查。该工程启动15个月后，省级眼科医生使用斯内伦视力表、便携式裂隙灯、手电筒和检眼镜对研究对象进行了检查。采用世界卫生组织（WHO）白内障手术效果监测记录表以及效果分类（视力，VA，≥0.3（6/18）为良好，VA<0.3但≥0.1（6/60）为临界，VA<0.1为差）来收集和分析数据。
总共99.7%的手术患者植入了人工晶状体。与WHO的建议相比，随访时效果良好（呈现的视力）的眼的比例较低（49.6%），而临界和差效果率较高（分别为34.1%和16.3%）。由国际非政府组织培训的县级外科医生所手术的眼与其他来访外科医生所手术的眼在随访时的效果存在显著差异（p<0.01）。
本研究记录了江西省“光明微笑工程”白内障手术良好效果的低发生率。该省白内障手术质量应进一步提高。
