Yan Xixi, Guan Chunhong, Mueller Andreas, Iezzi Beatrice, He Mingguang, Liang Hui, Meltzer Mirjam, Congdon Nathan G
Department of Preventive Ophthalmology and State Key Laboratory, Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , China .
Ophthalmic Epidemiol. 2013 Oct;20(5):294-300. doi: 10.3109/09286586.2013.821136. Epub 2013 Aug 29.
The recently completed Chinese "Million Cataract Surgeries Program" (MCSP) is among the largest such campaigns ever, providing 1.05 million operations. We report MCSP outcomes for the first time, in Jiangxi, the province with the greatest program output.
Ten county hospitals participating in MCSP were selected in Jiangxi (range of gross domestic product per capita US$743-2998). Each hospital sought to enroll 75 consecutive MCSP patients aged ≥ 50 years. Data recorded included type of cataract procedure, bilateral uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), and refractive error pre- and ≥ 50 days postoperatively.
Among 715 patients (mean age 72.3 ± 9.1 years, 55.5% female), preoperative UCVA was <3/60 (legally blind) bilaterally in 13.3% and unilaterally in the operated eye in 50.9%. No subjects had UCVA >6/18 preoperatively. Small incision cataract surgery was performed in 92.3% patients. Among 662 patients (92.6%) completing follow-up was ≥ 40 days after surgery, BCVA was ≥ 6/18 in 80.1%, UCVA was ≥ 6/18 in 57.1% and UCVA was <3/60 in 2.1%. Older age (p < 0.001), female sex (p = 0.04), worse refractive error (p = 0.02) and presence of intra- (p = 0.002) and postoperative surgical complications (p < 0.001), were independently associated with worse postoperative UCVA. Based on these results, the MCSP cured an estimated 124,950 cases (13.3% × [100-2.1%] × 1.05 million) of bilateral and 502,500 (50.9% × [100-2.1%] × 1.05 million) of unilateral blindness.
Due to relatively good outcomes and the large number of surgeries performed on blind persons, the sight-restoring impact of the MCSP was probably substantial.
近期完成的中国“百万白内障手术项目”（MCSP）是有史以来规模最大的此类活动之一，共实施了105万例手术。我们首次报告江西省这个项目产出最大省份的MCSP结果。
在江西省选取了10家参与MCSP的县级医院（人均国内生产总值范围为743 - 2998美元）。每家医院连续招募75例年龄≥50岁的MCSP患者。记录的数据包括白内障手术类型、双眼未矫正视力（UCVA）和最佳矫正视力（BCVA），以及术前和术后≥50天的屈光不正情况。
在715例患者（平均年龄72.3±9.1岁，女性占55.5%）中，术前双眼UCVA<3/60（法定盲）的占13.3%，手术眼单眼UCVA<3/60的占50.9%。术前无患者UCVA>6/18。92.3%的患者接受了小切口白内障手术。在662例（92.6%）术后随访≥40天的患者中，BCVA≥6/18的占80.1%，UCVA≥6/18的占57.1%，UCVA<3/60的占2.1%。年龄较大（p<0.001）、女性（p = 0.04）、屈光不正更严重（p = 0.02）以及存在术中（p = 0.002）和术后手术并发症（p<0.001）与术后UCVA较差独立相关。基于这些结果，MCSP估计治愈了124950例（13.3%×[100 - 2.1%]×105万）双眼失明病例和502500例（50.9%×[100 - 2.1%]×105万）单眼失明病例。
由于相对良好的结果以及对盲人实施的大量手术，MCSP对恢复视力的影响可能很大。
