Cataract Surgical Coverage Rate Research Articles

Prevalence and surgery status of cataract among adults aged 60 years or above in two villages of Nantong

Objective: To assess the prevalence, surgical coverage rate and social burden rate of cataract blindness among adults aged ≥60 years in the suburban population of Nantong, Jiangsu, China. Methods: It was a population-based cross-section study. A census with individuals aged ≥60 years was conducted in two villages of the suburb area in Nantong from June to August, 2008. A total of 1 305 individuals received visual acuity and eye examinations. Lens and cataract operative status were evaluated by slit-lamp biomicroscopy. Multiple logistic regression analysis was employed to analyze the prevalence of cataract, cataract surgical coverage rate and cataract blindness social burden rate among different ages, genders, educational backgrounds, marital statuses and salary levels. The results in the suburb were compared to the urban and rural areas. Results: Among 1 305 individuals, 376 cases of cataract were found. The prevalence of cataract was 28.81%. The rate was higher in the aged, less educated and low salary persons (P<0.01). In 47 eyes with cataract surgery, 19.15% of eyes were treated by modern extra-capsular surgery and 38.30% received phacoemulsification. The rate of intraocular lens implantation was 57.45%. The cataract surgical coverage rate was 40.48% and the cataract blindness social burden rate was 3.22%. The cataract surgical coverage rate was higher in the primary-educational persons than illiterate persons (P<0.05). The cataract blindness social burden rate was higher in ≥80-year-old persons than ≥60-year-old persons (P<0.05) and lower in married persons than single persons (P<0.05). The cataract surgical coverage rate was lower in the suburb area than in the city area, while the cataract blindness social burden rate was opposite. The rate of postoperative presenting visual acuity and best-corrected visual acuity of over 0.7 was 14.89% and 23.40% in the operated eyes, respectively. The main causes of unfavorable postoperative visual acuity (<0.3) were retinal disorders, post-capsular opacity, corneal opacity, refractive errors and glaucoma. Conclusions: Cataract is the most common and important eye disease that may lead to blindness and severe visual impairment among adults aged 60 years or above in the suburb of Nantong City. The prevalence of cataract is related to age, education background and economy level. The cataract surgical coverage rate is low and the cataract blindness social burden rate is high. The first important task in blindness prevention is still the elimination of cataract blindness and the improvement of visual outcomes after cataract surgery. (Chin J Ophthalmol, 2017, 53: 514-521).

Epidemiological survey on incidence of cataract in persons of 50 years or over in a resident district

Objective To investigate the prevalence of cataract, cataract surgery, cataract surgical coverage and the rate of blindness caused by cataract in persons of ≥50 years old in Liangyuan Residential District of Shangqiu City, Henan. Methods Cluster sampling was used in the study. Total of 5010 individuals aged≥50 years from Liangyuan Residential District were selected randomly during Sep. 2008 to Dec. 2008. All individuals received eye examination, including the evaluation degree of lens opacity and cataract surgical conditions by slit lamp biomicroscopy. The age, sex, education status, prevalence of cataract and cataract surgical coverage rate were analyzed by the multivariate regression analysis. Results In 5010 individuals, cataract was found in 1158 cases (23.11%). The prevalence of cataract was higher in the elderly female (P<0.01). In 96 eyes of 83 cases with cataract surgery, the modern extra-capsular cataract extraction was performed in 49 eyes (51.04%) and phocoemusification in 5 eyes(5.21%) respectively. The rate of intraocular lens implantation was 57.29%. Conclusion Cataract is the most common eye disease which lead to blindness and among elderly adults ≥50 years in Liangyuan District, Henan. In the district, there are low cataract coverage rate and the rate of intraocular lens implantation. Key words: Cataract; Prevalence; Cataract surgery; The elderly adults

Cataract surgical coverage rate among adults aged 40 years and older

Cataract is a leading cause of curable blindness. Hence, in its global declaration of ‘Vision 2020 Right to Sight’, the World Health Organization (WHO) encouraged its member countries to address the problem of incident cataract. Many factors are related to the cataract surgical coverage rate, such as gender and diabetes mellitus. The objective of this study was to determine the cataract surgical coverage rate and investigate the determinants factors of cataract surgical coverage rate among adults 40 years old and above with cataract. A cross sectional study was conducted using National Basic Health Research (Riskesdas) 2007 data. Cataract surgery was defined as surgery conducted within the last 12 months before the survey was performed. There were 6939 subjects (3105 male, 3834 female) who fulfilled the study criteria. The cataract surgical coverage rate was 19.3%. The cataract surgical coverage rate was lower in subjects with low education, in the group of farmers/fishermen/laborers, in the 40-49 years age group, in rural areas, and in subjects of low socioeconomic status (p&lt;0.05). The cataract surgical coverage rate was not different between gender and diabetes mellitus (p&gt;0.05). Determinants that were related to cataract surgical coverage rate were age, type of area of residence, socioeconomic status, and region of residence (p&lt;0.001). The implementation of educational programs and reforms to local ophthalmic health services may improve the cataract surgical coverage rate.

Rapid assessment of avoidable blindness in the northern eThekwini district of KwaZulu-Natal Province, South Africa

Aim: To determine the prevalence and causes of visual impairment, cataract surgical coverage and barriers to cataract surgery amongst people in the northern eThekwini district of KwaZuluNatal Province, South Africa.Method: Thirty-three clusters of 50 subjects ≥ 50 years old were randomly selected. Consenting subjects underwent enumeration to establish a demographic profile and thereafter a clinical examination. Visual acuity (VA) was measured with a Tumbling ‘E’ chart; participants having a VA &lt; 6/18 were retested with a pinhole. If no improvement in VA occurred, subjects underwent clinical examination, including a dilated fundus exam where necessary, to determine the cause of visual impairment.Results: Of the 1650 subjects selected, 1542 (93.5%) were examined. The overall prevalence of blindness was 1.9%. The age- and gender-adjusted prevalence of blindness was 2.1%, severe visual impairment (SVI) 1.2%, and moderate visual impairment (MVI) 3.9%. Untreated cataract was the major cause of blindness (55.2%) and SVI (53.3%), and uncorrected refractive error was the major cause of MVI (49.1%). The cataract surgical coverage rate was 70% at visual acuity &lt; 3/60 level; 51% at visual acuity &lt; 6/60 level; and 38% at visual acuity &lt; 6/18 level. Poor awareness of cataract surgical intervention was the main reason that participants with untreated cataracts had not used existing cataract services.Conclusion: The prevalence of blindness in the study region was lower (by 1.98%) than World Health Organization estimates of 9% for the Africa-E sub-region (within which South Africa falls). There is no permanent cataract service in this region; the lower cataract surgical coverage rates indicate that a permanent eye care centre could significantly alleviate avoidable blindness, particularly that caused by cataract.

Survey of the cataract prevalence and surgical coverage rate among 50 or above in Wuxi City

Background Cataract is the main blinding eye disease with an increasing prevalence in China.Objective Purpose of this study was to survey the prevalence of cataract and surgical coverage rate in 50 years old or above population in Wuxi City.Methods Cluster randomized sampling was used to organize the 6 722 residents aged 50 or above in 28 communities in Binhu District of Wuxi from January to December 2010 under the informed consent.Visual acuity was tested and ocular examination were performed.The incidence rate of cataract and surgical coverage rate of cataract were calculated.Results Total 6 150 individuals were collected in this survey with the response rate 91.5％.Lens opacification was examined in 1 564 subjects,with the prevalence of cataract 25.43％ (1 504/6 150).The prevalence of cataract was higher in the population with advanced age,female,illiterate,hypertension,diabetes,alcohol,smoking (x2 =927.835,18.508,303.968,11.934,17.956,32.091,35.290,all at P＜ 0.01).When the bilateral presenting vision＜0.05 was defined as the criterion,the odds ratio of cataractous blindness between with and without surgery was 3.15 (85/27).Cataract surgical coverage rate was 75.89％ (85/112),and the bilateral cataract-blindness burden was 1.82％ (112/6 150) in this region.The cataract surgical coverage rate was parallel to aging and lower education level,and there were statistically significant differences among the subjects with different ages or education levels (P＞0.01).However,the social burden rate of cataract-blindness was much higher in aged and lower education level population (P＜0.01).Conclusions The prevalence of cataract remains a high level in women,illiterates and elder individuals in Wuxi.The social burden shows an increasing trend in the bilateral cataract-blindness population with elder age and lower schooling.The prevention and treatment of cataract blindness still faces with a challenge. Key words: Cataract; Prevalence; Cataract surgical coverage rate; Blindness; Social and economical burden

Rapid Assessment of Avoidable Blindness in Two Northern Provinces of Burundi without Eye Services

Purpose: To determine the prevalence and causes of blindness, severe visual impairment and visual impairment as well as cataract surgical coverage in two northern provinces of Burundi for the purpose of planning eye services.Methods: The population-based Rapid Assessment of Avoidable Blindness survey methodology was used.Results: Of 3800 people enrolled, 3684 (97%) were examined. The sample prevalences of blindness, severe visual impairment, and visual impairment were 1.1% (95% confidence interval, CI 0.8–1.4), 0.6% (95% CI 0.4–0.9), and 1.7% (95% CI 1.3–2.1), respectively. The leading causes of blindness were cataract (55%) and posterior segment causes (37%). Severe visual impairment was mainly due to cataract (43%) and refractive error (39%), and visual impairment was mainly due to refractive error (67%) and cataract (18%). Cataract surgical coverage by person at the level of <6/60 was 15%.Conclusions: The low prevalence of vision loss in this area with no eye services and a low cataract surgical coverage rate is surprising and possibly due to the effects of the previous years of conflict in which those with decreased vision may have been most likely to perish. If this explanation is correct, then Burundi needs to plan to deal with a markedly increasing prevalence of cataract in future.

Survey of cataract rate and surgical coverage in agricultural and pastoral area of Chifeng Keshenketeng in Inner Mongolia

Background Cataract is a leading blinding eye disease,and the prevalence of cataract varies in different regions. Objective The present study was to investigate the incidence of cataract,surgical coverage rate of cataract and postoperative visual acuity,and to propose a strategy for blindness prevention in Chifeng Keshiketengqi. Methods This is a cross-sectional survey of research.A random cluster sampling method was performed in 12 populated areas in Keshiketengqi.Inhabitants over 50 years in the region were included in this survey.This study was approved by the Ethic Committee of Inner Mongolia People' s Hospital.Informed consents were obtained orally from all the subjects.Disease history,visual acuity,intraocular pressure and regular ophthamological examinations were performed.The inclusion criteria of a pilot study and detailed protocol were employed to calculate the incidence rate of cataract.The questionnaire survey was simultaneously adopted to analyze the cataract-related factors.The surgical coverage rate of cataract in this area was calculated. Results In a total 4234 inhabitants,3826 subjects participated in the survey with a response rate of 90.36％.Cataract was found in 1200 participants with an incidence rate of 31.39％.Age,the female gender and illiteracy were identified as risk factors for cataract (x2 =101.005,P =0.000 ;x2 =58.853,P =0.000 ;x2 =12.037,P =0.007 ).The prevalence rates of cataract were 36.98％ and 33.56％ for illiterates and women,respectively.The incidence rate in the Mongol population was significantly higher than that of the Han population ( 34.83％ vs.29.76％ ) (x2 =9.734,P =0.001 ).The cataract surgery rate increased yearly since 1998.When the vision acuity of the fellow eye was ＜0.1,the surgery coverage rate was 20.60％,but the rates were lower in female,illiterates and the Mongol population (x2 =1.993,P =0.038 ;x2 =16.463,P =0.044 ;x2 =8.523,P =0.029).When a pinhole visual acuity of ＜0.05 was determined as the criteria of blindness,the surgical coverage rate was 28.36％.The cataract surgical coverage rates for Han and Mongolian were 30.67％ and 24.53％,respectively,with a significant difference between them (x2 =12.951,P=0.000).The social burden rate was 3.34％ in this area,with a majority of females,illiterates and the Mongol population ( P＜0.05 ).Conclusions In agricultural and pastoral areas of Chifeng Keshiketengqi,the ≥50 years old population has a high rate of cataract blindness and low surgery coverage rate.Surgery is still the preferred way for cataract treatment. Key words: Cataract; Blindness prevention; Prevalence; Epidemiology; National minority

Coverage on cataract surgery among adults aged 40 or above in a multiethnic rural district of high altitude area in Gongshan county, Yunnan province, China

To estimate the prevalence of cataract and its surgical coverage rate together with the burden related to bilateral cataract-blindness, among adults aged 40 or above in Gongshan county of Yunnan province and to evaluate the current cataract status and the efficacy of local cataract prevention program. Cluster sampling was used. The protocol consisted of personal interview, pilot study, visual acuity checking, measuring the intraocular pressure; slit lamp microscopy and the fundus of the eye examination etc. Cataract was graded clinically using the Lens Opacity Classification System (LOCS) III. Bilateral cataract-blindness burden, bilateral cataract-blindness burden and cataract surgical coverage rate were calculated respectively, using two different criteria. Odds ratios (OR) were compared among different groups regarding age, gender, education, ethnic group and altitude of living area. Among the 1236 eligible residents, 1116 (90.3%) were enrolled in the present study. The prevalence of cataract was 23.8% among adults aged 40 or order. When the bilateral best refractive vision<3/60 was defined as the blindness criterion, the bilateral cataract-blindness burden showed as 1.3%, and cataract blindness surgical coverage rate was 50.0%. When the bilateral presenting vision<6/60 was defined as the blindness criterion, the bilateral cataract-blindness burden was 25.0%, and cataract blindness surgical coverage rate was 12.9%. The cataract surgical coverage rates were much lower and the bilateral cataract-blindness burden much higher in women, illiterates, living in high altitude areas and those who were aged 70 or above. Cataract blindness was a serious public health problem in aged individuals and illiteracy in the residents of the studied areas. Poor prevention programs on cataract called for urgent action to be taken.

Cataract blindness, surgical coverage, outcome, and barriers to uptake of cataract services in Plateau State, Nigeria

Purpose:The purpose was to estimate the prevalence of blindness due to cataract, assess visual outcomes of cataract surgery, and determine the cataract surgical coverage rate and barriers to uptake of services among individuals aged 50 years or older in Plateau State, Nigeria.Materials and Methods:A population-based, cross-sectional survey of 4200 adults 50 years or older was performed. Multistage stratified random sampling, with probability proportional to size was used to select a representative sample. The Rapid Assessment of Cataract Surgical Services protocol was used. Statistical significance was indicated by (P < 0.05).Results:The cohort comprised 4115 subjects (coverage: 98%). The prevalence of bilateral blindness due to cataract was 2.1%, [95% confidence intervals (CI): 1.7-2.5%] in the entire cohort, 2.4% in females (95% CI: 1.8-3.8%); and 1.8% in males (95% CI: 1.2-2.4%) (χ2 = 0.85, P > 0.05). The prevalence of monocular blindness due to cataract was 5.9% (95% CI: 5.2-6.6%). The cataract surgical coverage for subjects with visual acuity (VA) less 3/60 was 53.8% in the entire cohort; 60.5% for males and 48% for females (χ2 = 2.49, P > 0.05). The couching coverage for subjects who were blind was 12%. A total of 180 eyes underwent surgical intervention (surgery or couching) for cataract, of which, 48 (26.7%) eyes underwent couching. The prevalence of bilateral (pseudo) aphakia was 1.5%, (95% CI: 1.2-1.9%) and 2.7% (95% CI: 2.2-3.2%) for unilateral (pseudo) aphakia. Visual outcomes of the 180 eyes that underwent surgical intervention were good (VA ≥ 6/18) in 46 (25.6%) eyes and poor (VA < 6/60) in 105 (58.3%) eyes. Uncorrected aphakia was the most common cause of poor outcome (65.1%). Most subjects who underwent cataract surgery were not using spectacles 74 (71.2%). Cost and lack of awareness were the main barriers to uptake of cataract surgery services.Conclusion:Couching remains a significant challenge in Nigeria. The outcomes of cataract surgery are poor with the lack of aphakic correction being the main cause of the poor outcomes.

The global burden of cataract

To review the previous year's literature related to prevalence of blindness in general, blindness due to cataract, cataract surgical coverage (CSC) and cataract surgical rates (CSRs). Cataracts are the major cause of blindness and visual impairment in developing countries and contributes to more than 90% of the total disability adjusted life years. This review shows that coverage continues to be a problem in many countries, especially for the female population, those residing in rural areas and those who are illiterate. Although CSR is an indicator of the availability and acceptability of services, for measuring the impact of the program, we should look at combining CSR with CSC. This strategy would also enable us achieve our goal of eliminating avoidable blindness due to cataracts by the year 2020. Cataracts still continue- to be a major cause of blindness globally and with the rapidly aging population, it is a challenge to tackle. We need to plan a comprehensive strategy addressing issues related to availability, affordability, accessibility and acceptability of eye-care services.

Screening of cataract surgery in four rural populations aged 50 years old and above in western China

To estimate the cataract surgical coverage and cataract surgery rate and to assess the visual outcome of cataract surgery among individuals aged at or over 50 years old in four rural populations from four different areas of western China. This cross-sectional study, performed during the period 2003 - 2005, used the method of cluster sampling and recruited 5562 persons aged 50 years old or above through household census. Standardized ocular examinations including visual acuity test, intraocular pressure measurement, slit-lamp and fundus examination were performed. The main outcome criteria were cataract surgical coverage, cataract surgery rate, complication rate and visual outcome after cataract surgery. Of individuals with bilateral presenting visual acuity < 6/60 due to age-related cataract, the cataract surgical coverage was 54% in Qinghai. It was the highest among these four populations. The highest cataract surgery rate (CSR) value was 1551 in Qinghai and the lowest 143 in Guangxi during the period of 2000-2002. The overall intraocular lens implantation rate was 51.5% in 200 eyes with cataract surgery and 40.5% eyes with post-operative visual acuity < 6/60. The overall post-operative complication rate was 28%. In the beginning of 21st century, the cataract surgical coverage in four rural populations aged 50 years old or above in western China was low and similar to the situation of the last decade in eastern China. Cataract surgical technique and low IOL implantation rate are the main causes for a poor visual outcome. To reduce the risks of cataract blindness, the clinicians should substantially improve the visual outcome as well as the number of cataract surgery.

Cataract surgical coverage and outcome of cataract surgery in a rural district in Malawi

Background: Cataract is the leading cause of blindness in Malawi. We sought to determine the cataract surgical coverage and the outcome of cataract surgery in a rural district in Malawi to assess past performance of cataract surgical services.Methods: From July to October 1999 we conducted a multistage random cluster survey to include 1630 residents aged 50 years or more in Chikwawa District. Visual acuity, cause of vision loss, history of cataract surgery and cause of poor vision (if less than 6/60) were assessed. Cataract surgical coverage, sight restoration rate and outcome were calculated by person and eye and for men and women separately.Results: We examined 1384 people (84.9% of target). Twenty-one people (112 men and 9 women) (30 eyes) had received cataract surgery. The cataract surgical coverage rate was 35.6% (44.4% for men and 28.1% for women [odds ratio 2.0, 95% confidence interval 0.6–7.0]) at a visual acuity level of 6/60, and 55.3% (60.0% for men and 50.0% for women [odds ratio 1.5, 95% confidence interval 0.3–6.7]) at a level of 3/60. Only one eye of one subject had received an intraocular lens. Presenting visual acuity was 6/18 or better in 7 eyes (23.3%), 6/24 to 6/60 in 7 eyes, and worse than 6/60 in 16 eyes (53.3%). Among the 16 eyes with visual acuity less than 6/60, the vision could be improved in 8 with provision of aphakic spectacles.Interpretation: Cataract surgical coverage in this population is similar to that reported from other countries in Africa. As in other settings, cataract surgical coverage was lower in women than in men. Poor outcomes in this population are partly due to surgical complications and partly due to a lack of aphakic correction. Surgical promotion programs will need to focus on differentiating intraocular lens surgery from (previously practised) intracapsular cataract extraction surgery.