Duerksen Rainald, Limburg Hans, Lansingh Van C, Silva Juan Carlos
Fundación Visión , Asuncion , Paraguay .
Ophthalmic Epidemiol. 2013 Oct;20(5):301-7. doi: 10.3109/09286586.2013.821497.
To report the prevalence and causes of blindness in people aged 50 years and older in Paraguay, and to compare these with the previous national survey in 1999, focusing on planning of future eye care activities.
A rapid assessment of avoidable blindness (RAAB) was conducted in 2011. A total of 60 clusters of 50 residents aged 50 years and older were randomly selected and visited, and 2862 people were examined (95.4%). Survey data were analyzed with the RAAB software and compared with findings of a similar survey from 1999.
The prevalence of bilateral blindness in Paraguay was 1.0% (95% confidence interval, CI, 0.6-1.6) in 2011, significantly less than the 3.1% (95% CI 2.2-4.4) in 1999. Prevalence of bilateral cataract and cataract eyes had also reduced significantly for visual acuity, VA, <3/60, VA < 6/60 and VA < 6/18. Cataract surgical coverage in persons doubled to 90% for VA < 3/60, 78% for VA < 6/60 and 63% for VA < 6/18. Visual outcome after cataract surgery also improved to nearly the World Health Organization norm. Cataract was the main cause of blindness (43.8%), followed by severe visual impairment (40.5%). Uncorrected refractive errors were the main cause of moderate (78.0%) and the second cause of severe (18.9%) visual impairment.
The reduction in blindness and visual impairment due to cataract in Paraguay between 1999 and 2011 was highly significant. Results and coverage of cataract surgical services improved substantially. The reported numbers of cataract operations may not have been complete as these do not seem to match the dramatic improvement in the cataract situation in Paraguay.
报告巴拉圭50岁及以上人群的失明患病率及病因，并与1999年之前的全国性调查结果进行比较，重点关注未来眼保健活动的规划。
2011年开展了可避免失明快速评估（RAAB）。随机选取并走访了60个由50名50岁及以上居民组成的群组，共检查了2862人（95.4%）。使用RAAB软件对调查数据进行分析，并与1999年类似调查的结果进行比较。
2011年巴拉圭双眼失明患病率为1.0%（95%置信区间，CI，0.6 - 1.6），显著低于1999年的3.1%（95% CI 2.2 - 4.4）。双眼白内障及白内障患眼在视力低于3/60、视力低于6/60和视力低于6/18时的患病率也显著降低。视力低于3/60的人群白内障手术覆盖率翻倍至90%，视力低于6/60的人群为78%，视力低于6/18的人群为63%。白内障手术后的视觉效果也提升至接近世界卫生组织标准。白内障是失明的主要原因（43.8%），其次是严重视力损害（40.5%）。未矫正屈光不正为中度视力损害的主要原因（78.0%）及重度视力损害的第二大原因（18.9%）。
1999年至2011年期间，巴拉圭因白内障导致的失明和视力损害显著减少。白内障手术服务的结果及覆盖率大幅改善。所报告的白内障手术数量可能并不完整，因为这些数字似乎与巴拉圭白内障状况的显著改善不相符。
