Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
HelpMeSee, New York City, New York, USA; Instituto Mexicano de Oftalmología, Queretaro, Mexico.
Am J Ophthalmol. 2021 May;225:1-10. doi: 10.1016/j.ajo.2020.12.022. Epub 2021 Jan 4.
To provide an update of cataract as a cause of vision loss in Latin America and to analyze sex inequalities in cataract surgical coverage (CSC) and effective CSC (eCSC) in the region.
Population-based systematic review with longitudinal comparisons.
The Latin American and Caribbean Health Sciences Literature (LILACS) and PubMed databased were searched for population-based studies reporting cataract blindness, surgical coverage, and outcomes published between January 2014 and December 2019. Information on the number of surgeries performed from the 2014-2016 period was obtained from ministries of health and was used for calculation of the cataract surgical rate (CSR). Sources such as Rapid Assessment of Avoidable Blindness (RAAB) and Rapid Assessment of Cataract Surgical Services data were reanalyzed to calculate sex inequality in CSC and eCSC by subtracting the rate in women from the rate in men.
Cataract was the cause of 29.8%-77.6% of cases of blindness in the included studies; the CSR improved in 10 countries. The CSC pinhole visual acuity of 3/60 varied from 24.1% in Peru to 97.1% in Argentina, and the median absolute gender inequality CSC pinhole visual acuity 3/60 was -0.7%. The eCSC pinhole visual acuity 3/60 varied from 14.8% in Guatemala to 92.1% in Argentina, and the median absolute gender inequality eCSC pinhole visual acuity 3/60 was -0.8%.
Cataract remains a leading cause of blindness in Latin America. Coverage is suboptimal, and surgical results are also below target levels in many countries. Incentives for a better distribution of human resources, adequate training of ophthalmologists, and the inclusion of vision services in universal health care coverage could reduce the burden of cataract in Latin America.
提供拉丁美洲白内障致盲的最新信息，并分析该地区白内障手术覆盖率（CSC）和有效 CSC（eCSC）的性别不平等。
基于人群的系统评价，具有纵向比较。
在 LILACS 和 PubMed 数据库中搜索了 2014 年 1 月至 2019 年 12 月发表的关于白内障盲、手术覆盖率和结果的基于人群的研究。从卫生部获得了 2014-2016 年期间进行的手术数量信息，用于计算白内障手术率（CSR）。重新分析了快速性可避免盲评估（RAAB）和快速白内障手术服务评估等来源的数据，通过从男性比率中减去女性比率来计算 CSC 和 eCSC 的性别不平等。
白内障是纳入研究中 29.8%-77.6%盲病例的原因；10 个国家的 CSR 有所提高。针孔视力 3/60 的 CSC 从秘鲁的 24.1%到阿根廷的 97.1%不等，中位数绝对性别不平等 CSC 针孔视力 3/60 为-0.7%。针孔视力 3/60 的 eCSC 从危地马拉的 14.8%到阿根廷的 92.1%不等，中位数绝对性别不平等 eCSC 针孔视力 3/60 为-0.8%。
白内障仍然是拉丁美洲致盲的主要原因。在许多国家，覆盖率不理想，手术结果也低于目标水平。更好地分配人力资源、充分培训眼科医生以及将视力服务纳入全民健康覆盖范围等激励措施可以减轻拉丁美洲白内障的负担。
