Abstract
BackgroundAs a part of the Yunnan Minority Eye Studies, the purpose of this study was to determine the prevalence, barriers and visual acuity outcomes of cataract surgery in a multiethnic adult population in rural areas of southwestern China.MethodsA population-based cross-sectional survey was conducted with participants of Bai, Yi, and Han ethnicity aged ≥50 years in Yunnan. A detailed eye examination was performed. Information on the date, setting, type, and complications of cataract surgery were recorded in the examination of cataract-operated eyes.ResultsOf 6546 subjects (2133 Bai ethnicity, 2208 Yi ethnicity and 2205 Han ethnicity), the prevalence of cataract surgery was 6.0%, with 4.6% in Bai, 7.0% in Yi, and 6.4% in Han ethnicity. Cataract Surgical coverage (CSC) among those with presenting visual acuity (PVA) < 20/200 in both eyes because of cataract was 53.3%, with 52.8% in Bai, 64.4% in Yi, and 45.3% in Han ethnicity. CSC was associated with Yi ethnicity, younger age, and higher education level, while unoperated cataract was associated with Han ethnicity, older age, and illiterate. The main barrier to cataract surgery was lack of awareness and knowledge, cost, and fear. Among the 525 cataract-operated eyes, PVA and best-corrected visual acuity (BCVA) of 20/63 or better was 44.5 and 67.2%, respectively, with 48.1 and 65.9% in Bai, 47.8 and 75.4% in Yi, 39.1 and 59.9% in Han ethnicity. Han ethnicity, aphakia, earlier year of surgery, lower-level surgical hospital and illiterate were associated with postoperative visual impairment defined by PVA, while Han ethnicity, aphakia, and illiterate were associated with that defined by BCVA. The principal causes of postoperative visual impairment were retinal disorders (26.8%), posterior capsule opacification (25.1%), refractive error(22.7%), and glaucoma (9.3%).ConclusionsHan ethnicity had a lower CSC and relatively poor visual outcomes compared with ethnic minorities. Further effective effort to remove barriers and provide sight restoration is warranted.
Highlights
As a part of the Yunnan Minority Eye Studies, the purpose of this study was to determine the prevalence, barriers and visual acuity outcomes of cataract surgery in a multiethnic adult population in rural areas of southwestern China
As an important part of the Yunnan Minority Eye Studies (YMES), the aim of this study was to determine whether ethnicity is associated with the prevalence, barriers and visual acuity outcomes of cataract surgery in a multiethnic adult population residing in the same region in rural areas of southwestern China
Same random cluster sampling strategies were adopted to select Bai, Yi and Han people aged ≥50 years residing in rural areas in Yunnan, which is located in the southwestern China
Summary
As a part of the Yunnan Minority Eye Studies, the purpose of this study was to determine the prevalence, barriers and visual acuity outcomes of cataract surgery in a multiethnic adult population in rural areas of southwestern China. According to the World Health Organization (WHO) report of 2010, cataract is responsible for 51% of blindness and 33% of moderate and severe visual impairment [1]. Population-based studies in different regional, racial and ethnic groups have shown significant differences in cataract surgical uptake and visual outcomes of cataract surgery. Recent population-based studies in developing countries show that the surgical uptake continues to remain low because of barriers such as cost, fear, ageism, and lack of awareness and knowledge [2,3,4,5,6,7,8,9,10]. The vision recovery after cataract surgery is usually not optimistic in most developing countries, and often fails to meet the recommended standards set by WHO [11]
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