Li Zhijian, Song Zhen, Wu Shubin, Xu Keke, Jin Di, Wang Haijing, Liu Ping
Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University , Harbin , China.
Ophthalmic Epidemiol. 2014 Jun;21(3):161-8. doi: 10.3109/09286586.2014.903499. Epub 2014 Apr 4.
To report visual outcomes and barriers to uptake of cataract surgery among subjects of all ages in Mingshui County, Heilongjiang Province, China.
Cluster sampling was used to select a cross-sectional sample of people living in the Heilongjiang Province. Each subject underwent a participant interview, presenting and best-corrected vision measurements and an ocular examination. Visual outcomes and barriers to uptake of cataract surgery were assessed among subjects undergoing cataract surgery. Individuals who needed cataract surgery were interviewed regarding barriers.
Of 11,787 subjects, 10,384 eligible participants underwent visual acuity (VA) testing and a basic eye examination (88.1% response rate). The cross-sectional sub-sample of 21 participants receiving cataract surgery had a median age of 63 years. Six eyes undergoing surgery at the county hospital with conventional intracapsular and extracapsular cataract extraction without an intraocular lens implant were aphakic, and 15 eyes (71.4%) undergoing surgery at tertiary care hospitals were pseudophakic. Seven eyes (33.3%) had corrected VA ≥ 20/60, and nine eyes (42.9%) had presenting VA ≥ 20/60. Approximately 28.6% (6/21) had poor outcomes. The principal causes of presenting blindness after cataract surgery were refractive error/uncorrected aphakia and posterior capsular opacification. Cost was the most common barrier (73.9%) to uptake of cataract surgery.
Cataract surgical outcomes in northern China were poor. The principal barrier to uptake of cataract surgery was cost. These findings call for the establishment of cataract surgical services that are of high quality, affordable, and sensitive to high-risk groups.
报告中国黑龙江省明水县各年龄段人群白内障手术的视觉效果及手术接受障碍。
采用整群抽样方法选取黑龙江省居民的横断面样本。每位受试者均接受参与式访谈、视力及最佳矫正视力测量和眼部检查。对接受白内障手术的受试者评估其视觉效果及手术接受障碍。对需要进行白内障手术的个体就障碍因素进行访谈。
在11787名受试者中，10384名符合条件的参与者接受了视力（VA）测试和基本眼部检查（应答率为88.1%）。接受白内障手术的21名参与者的横断面子样本中位年龄为63岁。在县医院接受传统囊内和囊外白内障摘除且未植入人工晶状体的6只手术眼为无晶状体眼，在三级医院接受手术的15只眼（71.4%）为人工晶状体眼。7只眼（33.3%）矫正视力≥20/60，9只眼（42.9%）就诊视力≥20/60。约28.6%（6/21）的患者手术效果不佳。白内障手术后导致失明的主要原因是屈光不正/未矫正的无晶状体眼和后囊膜混浊。费用是接受白内障手术最常见的障碍（73.9%）。
中国北方白内障手术效果较差。接受白内障手术的主要障碍是费用。这些研究结果呼吁建立高质量、可负担且对高危人群敏感的白内障手术服务。
