Prevalence of blindness and outcomes of cataract surgery in Hainan Province in South China

To define the prevalence of blindness and visual impairment (VI) in people in rural Hainan using the rapid assessment of avoidable blindness (RAAB) and to report the outcomes of cataract surgery among the residents. Population-based, cross-sectional survey. A total of 6482 rural residents of the Hai...

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Vydané v:	Ophthalmology (Rochester, Minn.) Ročník 120; číslo 11; s. 2176
Hlavní autori:	Li, Emmy Y, Liu, Yingpeng, Zhan, Xingkai, Liang, Yuan Bo, Zhang, Xiujuan, Zheng, Chongren, Jhanji, Vishal, Xu, Ping, Chang, David F, Lam, Dennis S C
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States 01.11.2013
Predmet:	Age Distribution Aged Aged, 80 and over Blindness - epidemiology Cataract - epidemiology Cataract Extraction - statistics & numerical data China - epidemiology Cross-Sectional Studies Female Hospitals, Private - statistics & numerical data Hospitals, Public - statistics & numerical data Humans Lens Implantation, Intraocular - statistics & numerical data Male Middle Aged Prevalence Rural Population - statistics & numerical data Sex Distribution Treatment Outcome Vision, Low - epidemiology Visual Acuity - physiology Visually Impaired Persons - statistics & numerical data China
ISSN:	1549-4713, 1549-4713
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Abstract	To define the prevalence of blindness and visual impairment (VI) in people in rural Hainan using the rapid assessment of avoidable blindness (RAAB) and to report the outcomes of cataract surgery among the residents. Population-based, cross-sectional survey. A total of 6482 rural residents of the Hainan province. A total of 136 clusters, each of which consisted of 50 people aged ≥50 years, were selected through probability-proportionate-to-size sampling. Door-to-door visits were performed by 2 outreach teams. Visual acuity (VA) was measured on site, and those with VA <6/18 in either eye were examined by an ophthalmologist. Causes of blindness and VI were determined. The causes of poor visual outcome after cataract surgery were evaluated. Information regarding barriers to receiving surgery was collected by trained interviewers. Prevalence and causes of blindness (VA <3/60), severe VI (SVI) (VA <6/60 but ≥3/60), and VI (VA <6/18 but ≥6/60) based on presenting VA (PVA) were assessed. Outcomes of cataract surgery performed in public and private hospitals and charitable organizations were compared. A total of 6482 subjects were examined (response rate, 95.3%). The sample prevalence of blindness was 4.4% (95% confidence interval [CI], 2.0-6.8). The prevalence of SVI and VI was 1.9% (95% CI, 0-4.3) and 9.9% (95% CI, 7.6-12.2), respectively. Age and sex were associated with increased prevalence of blindness, SVI, and VI. Overall, cataract accounted for approximately 60% of blindness and SVI. Of the 524 eyes that had received cataract surgery, 87.2% had intraocular lenses implanted, 21% had a poor visual outcome (PVA <6 /60), and 20% had a borderline visual outcome (PVA <6/18 but ≥6/60). Eyes that received surgery in charitable organizations had a higher rate of intraocular lens implantation and good visual outcome (VA ≥6/18) compared with eyes that were operated on elsewhere. The prevalence of blindness, SVI, and VI was high among rural residents in Hainan. Cataract remained the leading cause of avoidable blindness. Outcomes of cataract surgery performed in public hospitals were suboptimal. Quality-control initiatives should be introduced to improve cataract surgery outcomes.
AbstractList	To define the prevalence of blindness and visual impairment (VI) in people in rural Hainan using the rapid assessment of avoidable blindness (RAAB) and to report the outcomes of cataract surgery among the residents. Population-based, cross-sectional survey. A total of 6482 rural residents of the Hainan province. A total of 136 clusters, each of which consisted of 50 people aged ≥50 years, were selected through probability-proportionate-to-size sampling. Door-to-door visits were performed by 2 outreach teams. Visual acuity (VA) was measured on site, and those with VA <6/18 in either eye were examined by an ophthalmologist. Causes of blindness and VI were determined. The causes of poor visual outcome after cataract surgery were evaluated. Information regarding barriers to receiving surgery was collected by trained interviewers. Prevalence and causes of blindness (VA <3/60), severe VI (SVI) (VA <6/60 but ≥3/60), and VI (VA <6/18 but ≥6/60) based on presenting VA (PVA) were assessed. Outcomes of cataract surgery performed in public and private hospitals and charitable organizations were compared. A total of 6482 subjects were examined (response rate, 95.3%). The sample prevalence of blindness was 4.4% (95% confidence interval [CI], 2.0-6.8). The prevalence of SVI and VI was 1.9% (95% CI, 0-4.3) and 9.9% (95% CI, 7.6-12.2), respectively. Age and sex were associated with increased prevalence of blindness, SVI, and VI. Overall, cataract accounted for approximately 60% of blindness and SVI. Of the 524 eyes that had received cataract surgery, 87.2% had intraocular lenses implanted, 21% had a poor visual outcome (PVA <6 /60), and 20% had a borderline visual outcome (PVA <6/18 but ≥6/60). Eyes that received surgery in charitable organizations had a higher rate of intraocular lens implantation and good visual outcome (VA ≥6/18) compared with eyes that were operated on elsewhere. The prevalence of blindness, SVI, and VI was high among rural residents in Hainan. Cataract remained the leading cause of avoidable blindness. Outcomes of cataract surgery performed in public hospitals were suboptimal. Quality-control initiatives should be introduced to improve cataract surgery outcomes. To define the prevalence of blindness and visual impairment (VI) in people in rural Hainan using the rapid assessment of avoidable blindness (RAAB) and to report the outcomes of cataract surgery among the residents.OBJECTIVETo define the prevalence of blindness and visual impairment (VI) in people in rural Hainan using the rapid assessment of avoidable blindness (RAAB) and to report the outcomes of cataract surgery among the residents.Population-based, cross-sectional survey.DESIGNPopulation-based, cross-sectional survey.A total of 6482 rural residents of the Hainan province.PARTICIPANTSA total of 6482 rural residents of the Hainan province.A total of 136 clusters, each of which consisted of 50 people aged ≥50 years, were selected through probability-proportionate-to-size sampling. Door-to-door visits were performed by 2 outreach teams. Visual acuity (VA) was measured on site, and those with VA <6/18 in either eye were examined by an ophthalmologist. Causes of blindness and VI were determined. The causes of poor visual outcome after cataract surgery were evaluated. Information regarding barriers to receiving surgery was collected by trained interviewers.METHODSA total of 136 clusters, each of which consisted of 50 people aged ≥50 years, were selected through probability-proportionate-to-size sampling. Door-to-door visits were performed by 2 outreach teams. Visual acuity (VA) was measured on site, and those with VA <6/18 in either eye were examined by an ophthalmologist. Causes of blindness and VI were determined. The causes of poor visual outcome after cataract surgery were evaluated. Information regarding barriers to receiving surgery was collected by trained interviewers.Prevalence and causes of blindness (VA <3/60), severe VI (SVI) (VA <6/60 but ≥3/60), and VI (VA <6/18 but ≥6/60) based on presenting VA (PVA) were assessed. Outcomes of cataract surgery performed in public and private hospitals and charitable organizations were compared.MAIN OUTCOME MEASURESPrevalence and causes of blindness (VA <3/60), severe VI (SVI) (VA <6/60 but ≥3/60), and VI (VA <6/18 but ≥6/60) based on presenting VA (PVA) were assessed. Outcomes of cataract surgery performed in public and private hospitals and charitable organizations were compared.A total of 6482 subjects were examined (response rate, 95.3%). The sample prevalence of blindness was 4.4% (95% confidence interval [CI], 2.0-6.8). The prevalence of SVI and VI was 1.9% (95% CI, 0-4.3) and 9.9% (95% CI, 7.6-12.2), respectively. Age and sex were associated with increased prevalence of blindness, SVI, and VI. Overall, cataract accounted for approximately 60% of blindness and SVI. Of the 524 eyes that had received cataract surgery, 87.2% had intraocular lenses implanted, 21% had a poor visual outcome (PVA <6 /60), and 20% had a borderline visual outcome (PVA <6/18 but ≥6/60). Eyes that received surgery in charitable organizations had a higher rate of intraocular lens implantation and good visual outcome (VA ≥6/18) compared with eyes that were operated on elsewhere.RESULTSA total of 6482 subjects were examined (response rate, 95.3%). The sample prevalence of blindness was 4.4% (95% confidence interval [CI], 2.0-6.8). The prevalence of SVI and VI was 1.9% (95% CI, 0-4.3) and 9.9% (95% CI, 7.6-12.2), respectively. Age and sex were associated with increased prevalence of blindness, SVI, and VI. Overall, cataract accounted for approximately 60% of blindness and SVI. Of the 524 eyes that had received cataract surgery, 87.2% had intraocular lenses implanted, 21% had a poor visual outcome (PVA <6 /60), and 20% had a borderline visual outcome (PVA <6/18 but ≥6/60). Eyes that received surgery in charitable organizations had a higher rate of intraocular lens implantation and good visual outcome (VA ≥6/18) compared with eyes that were operated on elsewhere.The prevalence of blindness, SVI, and VI was high among rural residents in Hainan. Cataract remained the leading cause of avoidable blindness. Outcomes of cataract surgery performed in public hospitals were suboptimal. Quality-control initiatives should be introduced to improve cataract surgery outcomes.CONCLUSIONSThe prevalence of blindness, SVI, and VI was high among rural residents in Hainan. Cataract remained the leading cause of avoidable blindness. Outcomes of cataract surgery performed in public hospitals were suboptimal. Quality-control initiatives should be introduced to improve cataract surgery outcomes.
Author	Zhan, Xingkai Liu, Yingpeng Li, Emmy Y Zheng, Chongren Liang, Yuan Bo Lam, Dennis S C Chang, David F Zhang, Xiujuan Xu, Ping Jhanji, Vishal
Author_xml	– sequence: 1 givenname: Emmy Y surname: Li fullname: Li, Emmy Y organization: Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Project Vision Charitable Foundation, Hong Kong SAR, China; Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China – sequence: 2 givenname: Yingpeng surname: Liu fullname: Liu, Yingpeng – sequence: 3 givenname: Xingkai surname: Zhan fullname: Zhan, Xingkai – sequence: 4 givenname: Yuan Bo surname: Liang fullname: Liang, Yuan Bo – sequence: 5 givenname: Xiujuan surname: Zhang fullname: Zhang, Xiujuan – sequence: 6 givenname: Chongren surname: Zheng fullname: Zheng, Chongren – sequence: 7 givenname: Vishal surname: Jhanji fullname: Jhanji, Vishal – sequence: 8 givenname: Ping surname: Xu fullname: Xu, Ping – sequence: 9 givenname: David F surname: Chang fullname: Chang, David F – sequence: 10 givenname: Dennis S C surname: Lam fullname: Lam, Dennis S C
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SubjectTerms	Age Distribution Aged Aged, 80 and over Blindness - epidemiology Cataract - epidemiology Cataract Extraction - statistics & numerical data China - epidemiology Cross-Sectional Studies Female Hospitals, Private - statistics & numerical data Hospitals, Public - statistics & numerical data Humans Lens Implantation, Intraocular - statistics & numerical data Male Middle Aged Prevalence Rural Population - statistics & numerical data Sex Distribution Treatment Outcome Vision, Low - epidemiology Visual Acuity - physiology Visually Impaired Persons - statistics & numerical data
Title	Prevalence of blindness and outcomes of cataract surgery in Hainan Province in South China
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