Tan Xuhua, Wang Wei, Zhu Yi, Chen Chuan, Qiu Xiaozhang, Xu Jingmin, Hou Chao, Luo Lixia, Huang Wenyong, Liu Yizhi
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Ann Transl Med. 2020 Oct;8(19):1222. doi: 10.21037/atm-20-396.
Strategy establishment for improving the efficiency and sustainability of cataract surgical output is important for eye health program. The aim of this study is to assess the three-year output of a novel cataract screening model integrated into establishment of resident health record in a rural area of south China.
A novel cataract screening model which combined private hospital screening and annual health examinations for establishing resident health record from January 2015 to December 2017 was implemented in an eye hospital in Zhaoqing, Guangdong, China. Demographic information and cataract surgery rate were recorded. A subgroup of patients who underwent cataract surgery were surveyed by customized questionnaire to determine the accessibility to eye-care services and barriers to cataract surgery.
A total of 172,814 people aged ≥50 years in Zhaoqing were screened and 56,292 (32.57%) people were diagnosed with age-related cataract, among whom 18,422 (10.66%) with a best corrected visual acuity (BCVA) less than 20/63 were recommended for cataract surgery. Surgery was performed on 11,105 (60.28%) recommended patients. After the introduction of this screening model, the cataract surgical rate (CSR) in this area dramatically increased to 2,739/million/y (by 1.8 folds) in 2015 and 3,678/million/y (by 2.4 folds) in 2017, compared with that in 2014 (1,520/million/y). Accessibility to eye-care service was improved, and the main reason for not receiving cataract surgery changed from misconception of cataract to having good vision in the fellow eye after 3 years of screening.
This study documented the benefit of a novel cataract screening model integrated into establishment of resident health record in rural China, which may serve as a cost-effective, practicable, and sustainable strategy to disseminate cataract knowledge and eliminate cataract blindness.
制定提高白内障手术效率和可持续性的策略对眼健康项目至关重要。本研究旨在评估一种新型白内障筛查模式在华南农村地区居民健康档案建立中的三年产出情况。
2015年1月至2017年12月，在中国广东肇庆的一家眼科医院实施了一种新型白内障筛查模式，该模式将私立医院筛查与年度健康检查相结合以建立居民健康档案。记录人口统计学信息和白内障手术率。对接受白内障手术的患者亚组进行定制问卷调查，以确定获得眼保健服务的可及性和白内障手术的障碍。
肇庆市共筛查了172,814名年龄≥50岁的人群，其中56,292人（32.57%）被诊断为年龄相关性白内障，其中18,422人（10.66%）最佳矫正视力（BCVA）低于20/63，被建议进行白内障手术。11,105名（60.28%）被建议的患者接受了手术。引入该筛查模式后，该地区的白内障手术率（CSR）在2015年大幅提高至2,739/百万/年（增长了1.8倍），在2017年提高至3,678/百万/年（增长了2.4倍），而2014年为1,520/百万/年。眼保健服务的可及性得到改善，经过3年的筛查，未接受白内障手术的主要原因从对白内障的误解转变为对侧眼视力良好。
本研究记录了一种新型白内障筛查模式在农村地区居民健康档案建立中的益处，这可能是一种具有成本效益、可行且可持续的策略，用于传播白内障知识和消除白内障致盲。
