Six-Year Change in Cataract Surgical Coverage and Postoperative Visual Outcomes in Rural Southern China: The Yangxi Eye Study.

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology Pub Date : 2023-11-01 Epub Date: 2023-11-15 DOI:10.1097/APO.0000000000000643

Xia Gong, Liwen Deng, Zeyu Yao, Liqiong Xie, Xinyu Zhao, Kun Xiong, Wangting Li, Yuanping Liu, Meng Yuan, Nathan Congdon, Mingguang He, Xiaoling Liang, Wenyong Huang

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引用次数: 0

Abstract

Purpose: The purpose of this study was to investigate a 6-year change in cataract surgical coverage (CSC), effective cataract surgical coverage (eCSC), and visual outcomes in an elderly population in rural southern China.

Design: This is a prospective population-based study with a 6-year follow-up.

Methods: The study included rural residents aged 50 years and above in southern China with comprehensive eye examinations at baseline and follow-up in 2014 and 2020, respectively.

Results: Five thousand six hundred thirty-eight participants underwent baseline examinations (mean age 66.1±10.2 y, 50.8% women); and 3141 (64.9%) of 4841 eligible survivors attended the 6-year follow-up. Cataract surgical coverage was 41.7% and 40.6% at baseline and follow-up, respectively, while eCSC were 32.6% and 26.6%. In multivariate models, the 6-year likelihood of cataract surgery decreased with older age [odds ratio (OR)=0.97 per year, 95% confidence interval (CI): 0.94, 0.99, P =0.012] and worse baseline presenting uncorrected visual acuity (PVA) in the worse-seeing eye (OR=0.35 per unit logarithm of the minimum angle of resolution (logMAR), 95% CI: 0.25, 0.48, P <0.001), and increased with prior cataract surgical history at baseline (OR=3.88, 95% CI: 1.91, 7.09, P <0.001). The likelihood of receiving effective cataract surgery decreased with worse baseline PVA in the worse eye (OR=0.49 per unit logMAR, 95% CI: 0.24, 0.97, P =0.042) and better-seeing eye (OR=0.68 per unit logMAR, 95% CI: 0.48, 0.95, P =0.026). Posterior capsular opacification was the main reason for PVA <6/18, reporting it in logMAR (0.5) in operated eyes (38.4% at baseline; 28.1% at follow-up).

Conclusions: World Health Organization has established a global target of increasing eCSC by 30% before 2030, but no increase was found in rural southern China between 2014 and 2020, let alone reaching the World Health Organization target of 56.3%. Strategies to improve surgery incidence should focus on older persons and those with worse preoperative PVA.

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中国南方农村地区6年白内障手术覆盖率和术后视力的变化:杨溪眼科研究

目的:本研究的目的是调查中国南方农村老年人白内障手术覆盖率(CSC)、有效白内障手术覆盖率(eCSC)和视力结果的6年变化。设计:这是一项基于人群的前瞻性研究，随访6年。方法:研究对象为中国南方50岁及以上农村居民，分别于2014年和2020年基线和随访时进行全面眼科检查。结果:5638名参与者接受了基线检查(平均年龄66.1±10.2岁，女性50.8%);4841名符合条件的幸存者中有3141名(64.9%)参加了6年的随访。在基线和随访时，白内障手术覆盖率分别为41.7%和40.6%，而eCSC为32.6%和26.6%。在多变量模型中，6年白内障手术的可能性随着年龄的增长而下降[比值比(OR)=0.97 /年，95%可信区间(CI): 0.94, 0.99, P=0.012]，并且在视力较差的眼睛中出现未矫正视力(PVA)的基线较差(OR=0.35 /最小分辨角(logMAR)的单位对数，95% CI: 0.25, 0.48, P)。世界卫生组织制定了到2030年将eCSC提高30%的全球目标，但在2014年至2020年期间，中国南方农村没有发现eCSC的增长，更不用说达到世界卫生组织56.3%的目标。提高手术发生率的策略应侧重于老年人和术前PVA较差的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia-Pacific Journal of Ophthalmology OPHTHALMOLOGY-

CiteScore

8.10

自引率

18.20%

发文量

197

审稿时长

6 weeks

期刊介绍： The Asia-Pacific Journal of Ophthalmology, a bimonthly, peer-reviewed online scientific publication, is an official publication of the Asia-Pacific Academy of Ophthalmology (APAO), a supranational organization which is committed to research, training, learning, publication and knowledge and skill transfers in ophthalmology and visual sciences. The Asia-Pacific Journal of Ophthalmology welcomes review articles on currently hot topics, original, previously unpublished manuscripts describing clinical investigations, clinical observations and clinically relevant laboratory investigations, as well as .perspectives containing personal viewpoints on topics with broad interests. Editorials are published by invitation only. Case reports are generally not considered. The Asia-Pacific Journal of Ophthalmology covers 16 subspecialties and is freely circulated among individual members of the APAO’s member societies, which amounts to a potential readership of over 50,000.