Zhao J, Sui R, Jia L, Fletcher A E, Ellwein L B
Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.
Am J Ophthalmol. 1998 Oct;126(4):515-23. doi: 10.1016/s0002-9394(98)00274-8.
To measure visual acuity and vision-related quality of life in individuals in rural China operated on for cataract.
Five thousand fifty-two persons age 50 years and older, 90.9% (5,052/5,555) of a randomly selected population in Shunyi County, were examined in the fall of 1996. Visual functioning and quality of life questionnaires were administered to those with presenting visual acuity less than 6/60 in either eye and to those who were aphakic or pseudophakic.
Of the 87 individuals operated on for cataract, 12% (10/87) had presenting visual acuity of 6/18 or more in both eyes, and 24.1% (21/87) had less than 6/60. Twenty-five percent (29/116) of the 116 eyes operated on for cataract had presenting visual acuity of 6/18 or more, and 44.8% (52/116) had less than 6/60. Aphakic cases without glasses and uncorrectable aphakia attributable to surgical complications were common. In a multivariate regression model, including time period of surgery, hospital type, and surgical procedure, only pseudophakia was associated with better outcomes (P = .05). On a scale from 0 (maximum problems) to 100 (no problems), the mean visual functioning score (+/-SD) for the operated-on population was 61.9 +/- 30.0, and 71.0 +/- 31.8 for the quality of life questionnaire. These scores were comparable to those of the unoperated-on population with moderate bilateral blindness (<6/60 to > or =3/60 in the better eye). Visual functioning and quality of life scores were closely correlated with visual acuity in operated-on (r = 0.64 and r = 0.61, respectively) and unoperated-on populations (r = 0.68 and r = 0.59, respectively).
Both clinical and patient-reported cataract surgery outcomes are below what should be achievable. Improvement in outcomes must be given greater emphasis if the potential of cataract surgery in restoring sight is to be realized.
测量中国农村接受白内障手术患者的视力及与视力相关的生活质量。
1996年秋季对顺义县5555名随机抽取人群中年龄50岁及以上的5052人（占90.9%，即5052/5555）进行了检查。对双眼视力低于6/60以及无晶状体或人工晶状体眼的患者进行了视觉功能和生活质量问卷调查。
在87例接受白内障手术的患者中，12%（10/87）双眼术后视力达到6/18或更好，24.1%（21/87）低于6/60。在116只接受白内障手术的眼中，25%（29/116）术后视力达到6/18或更好，44.8%（52/116）低于6/60。无眼镜的无晶状体眼病例以及因手术并发症导致的无法矫正的无晶状体眼很常见。在一个多变量回归模型中，纳入手术时间、医院类型和手术方式等因素后，只有人工晶状体植入与更好的预后相关（P = 0.05）。在从0（最大问题）到100（无问题）的评分量表上，接受手术人群的平均视觉功能评分（±标准差）为61.9±3.0，生活质量问卷评分为71.0±31.8。这些评分与中度双眼盲（较好眼视力<6/60至≥3/60）的未接受手术人群相当。接受手术人群和未接受手术人群的视觉功能和生活质量评分与视力密切相关（接受手术人群中r分别为0.64和0.61，未接受手术人群中r分别为0.68和0.59）。
临床及患者报告的白内障手术效果均低于应达到的水平。若要实现白内障手术恢复视力的潜力，必须更加重视改善手术效果。
