沙湾县45岁及以上人群盲与低视力流行病学调查与治疗

目的调查新疆沙湾县≥45岁人群中盲与低视力患病率及致盲原因。方法采用分层整群随机抽样法,抽取8个基本抽样单位内的1322例≥45岁的患者作为调查对象。采用WHO盲与低视力标准由眼科医生作外眼、前房、晶状体、眼底等检查,对所有视力<03的患眼进行主要眼病原因诊断。结果1322列中受检1208例,总受检率9134%,盲目患病率为141%。低视力患病率为339%,致盲的主要眼病依次为白内障(4634%)、角膜病(1707%)、青光眼(976%)、玻璃体视网膜病(1463%)等。结论白内障仍占致盲和低视力病因的首位,今后防盲治盲的重点应是白内障的手术复明。     

新疆库车县40岁以上维吾尔族农民盲和低视力流行病学调查

目的调查新疆库车县年龄≥40岁维吾尔族农民盲与低视力的患病率及主要致盲原因。方法采用整群随机抽样方法,按世界卫生组织盲目分类标准对随机抽取的新疆库车县2955名维吾尔族农民进行视力调查,对针孔镜下视力低于0.3者进行眼部检查并做主要致盲原因诊断。结果共录入3692人,实际受检2955人,受检率为80.0%。其中双盲患病率为2.1%,双眼低视力患病率为9.9%。60岁组双盲患病率是40岁组的13.5倍,差异有统计学意义(P<0.01);男性双盲患病率是女性的1.4倍,差异无统计学意义(P>0.05);文盲组双盲患病率是非文盲组的4.5倍,差异有统计学意义(P<0.01)。结论新疆库车县年龄≥40岁维吾尔族农民盲及低视力患病率高于国内部分地区,首要致盲眼病仍为白内障,故降低白内障患病率是该地区防盲治盲的关键。     

三亚市郊≥50岁人群低视力及盲流行病学调查

目的:调查海南省三亚市郊≥50岁人群中低视力及盲的发病率并分析其原因。方法:随机抽取28个抽样单位的≥50岁人群共2569例进行调查。对调查人员进行矫正视力、外眼、前房、晶状体、玻璃体及眼底检查。观察其低视力及盲的患病率,分析致盲的重要原因。结果:2569例中受检2206例,受检率85.87%,低视力和盲的患病率分别为3.85%和1.90%。致盲主要眼病依次为白内障、青光眼、角膜病、眼睑疾病及翼状胬肉。结论:白内障依然是低视力和盲的首要病因,但眼睑疾病及翼状胬肉致盲也不容忽视。     

广西合浦县白内障致盲及低视力的调查

目的调查广西合浦县白内障致盲及低视力的患病率及白内障手术负荷量。方法 2006年对广西合浦县4个乡镇8个自然小区人群进行检查。双眼视力〈0.05者为白内障盲人,〈0.3者为白内障低视力患者,〈0.1者为白内障手术对象。结果调查人群3270人,实检人数2800人,受检率为85.6%。白内障致盲率为1.89%,低视力患病率为2.71%,白内障手术负荷量为2.18%。结论广西合浦县白内障致盲率及低视力患病率较高,白内障手术复明是目前防盲治盲的首要任务。     

甘肃省平凉市崆峒区人群盲和低视力现况调查

目的:探讨与了解甘肃省平凉市崆峒区人群盲与低视力的患病率及致病原因。方法:应用横断面研究的流行病学调查方法,以村(社区)为基础,采用随机整群抽样原则抽取6个乡镇2个街道办事处作为调查地点。采用世界卫生组织制定的盲与低视力标准,对全区按0.719%抽样比例抽取样本进行盲与低视力的流行病学调查。结果:检录3235例中,受检人数为2801例,受检率为86.58%,双眼盲21例,盲率为0.75%(男0.59%,女0.91%);双眼低视力125例,低视力患病率为4.46%(男3.73%,女5.16%),≥60岁以上盲与低视力患者的患病率明显增高。致盲病因前三位的眼病依次为白内障(47.62%)、角膜病(14.29%)、青光眼(14.29%)。结论:崆峒区人群中盲和低视力的眼病以白内障居首位,因此手术治疗白内障仍是今后防盲治盲工作的首要任务。     

上海浦东三林镇老年人盲和低视力流行病学调查

目的调查上海市浦东新区三林镇70岁及以上老年人盲和低视力的患病率及致病原因。方法以世界卫生组织制定的分级为标准,使用针孔镜矫正视力,统计其盲与低视力患病率,分析盲及低视力的主要病因。结果盲及低视力患病率分别为2.4%和8.8%,致盲和低视力的眼病均以白内障居首位,其次为老年性黄斑变性、角膜病和青光眼等。结论手术治疗白内障是降低盲与低视力患病率的主要措施,老年性黄斑变性等难治性眼病的防治亦应成为防盲治盲工作的重点。     

上海市金山区廊下镇老年人盲和低视力流行病学研究

目的研究上海市金山区廊下镇60岁及以上人群的盲和低视力患病率、致盲病因及其相关因素。方法对目标人群进行整群抽样。对调查对象完成视力、眼压、验光、裂隙灯、免散瞳数字眼底照相等检查,采用最佳矫正视力和日常生活视力及其视力损伤标准确立盲或低视力,并明确主要病因。结果本研究实际受检2150人,受检率为80.95%。按照最佳矫正视力损伤标准分类:双眼盲35例,患病率为1.63%;双眼低视力176例,患病率8.18%,白内障、黄斑变性、角膜病、眼球萎缩或缺如、糖尿病视网膜病变是前五位主要病因;女性盲患病率(2.10%)高于男性(0.86%),差异有统计学意义(P<0.05)。按照日常生活视力损伤标准分类:双眼盲43例,患病率为2.00%;双眼低视力467例,患病率为21.72%;女性低视力患病率(8.99%)高于男性(7.00%),差异有统计学意义(P<0.05);白内障、未矫正的屈光不正、黄斑变性、角膜病、眼球萎缩或缺如是前五位主要病因。结论对于上海农村地区的老年人,必须通过加强白内障复明手术的实施、屈光不正的矫正、眼底退变性疾病的筛查和干预来提高防盲治盲的效率。     

广州市萝岗区盲与低视力流行病学调查

目的 调查广州市萝岗区年龄≥50岁人群盲与低视力的患病率及主要致病原因.方法 采用整群抽样方法 ,按世界卫生组织盲与低视力分类标准,对广州市萝岗区50岁及以上人群进行问卷调查,视力检测初筛后对针孔镜下视力低于0.3者,由眼科医师做视功能、眼前后节形态检查及主要致盲原闪诊断.结果 共录入人数4532人,实际受检4126人,受检率91.04%.其中双眼肓患病率为1.91%,单眼盲患病率5.96%,双眼低视力患病率8.41%.随着年龄增加,盲与低视力患病率明显升高.70岁年龄组双眼肓是50岁年龄组的25.5倍,差异具有统计学意义(P<0.01).在盲与低视力人群中致病原因的前几位依次是白内障(47.9%),眼底病(20.4%),屈光不正(9.52%),角膜病(7.59%).另外,脑垂体瘤致盲占0.74%.结论 广州市萝岗区≥50岁老年人群盲与低视力的首要原因为白内障,故降低自内障的患病率是该地区防旨治盲的关键,另外眼底病在该地区也是重点防治的疾病.     

陕西省农村50岁及以上人群白内障流行病学调查

目的：调查陕西省农村50岁及以上人群白内障患病率及手术情况,并评价由白内障造成的致盲率及术后效果。

方法：于2011-01/12采用整体随机分层抽样方法,在陕西省留坝县、黄陵县、蓝田县调查3 494人,其中≥50岁人群2 124人。所有调查对象均进行标准问卷调查及详细的眼科检查。采用WHO视力诊断标准和我国白内障诊断标准进行评价。

结果：实际受检者1 912人,应答率为90.0%。调查人群的白内障患病率为36.66%,其中50岁人群白内障患病率为15.80%,70岁以上人群则上升到68.71%,白内障的患病率随着年龄增长而明显上升(P<0.01)。此人群白内障致双眼盲和双眼低视力患病率分别为1.99%和7.17%,其中50岁人群双眼盲、单眼盲、双眼低视力、单眼低视力患病率分别为0.51%,0.63%,1.90%,2.53%,70岁以上人群患病率分别上升到4.55%,5.35%,16.44%,18.81%。不同年龄组白内障致盲与低视力患病率均有显著差异,且随着年龄增长而明显升高,差异均有统计学意义(P<0.01)。在86只白内障手术眼中,实施ECCE手术眼58只,实施PHACO手术眼23只,实施ICCE手术眼5只。其中术后矫正视力≥0.3术眼中ECCE占69.09%,PHACO占23.64%,ICCE占7.27%,脱残率为63.95%,脱盲率为91.86%。

结论：目前白内障在陕西省农村仍然是一个比较严重的公共卫生问题。陕西省防盲工作取得了一定的成绩,白内障的患病率、致盲率均有一定程度的降低。PHACO手术已在农村开展,但PHACO的普及率和手术技术需进一步提高。     

天津蓟县桑梓村40岁及以上人群白内障患病率调查

目的　调查天津蓟县桑梓村 40岁以上白内障患病率、白内障致盲率及白内障手术负荷量。方法　 2 0 0 3年 1～ 3月 ,对天津蓟县桑梓村 40岁以上人群进行白内障的检查 ,白内障患者定义为至少 1只眼晶状体混浊并致视力 <0 7者 ,其中双眼视力 <0 0 5者为白内障盲人 ,双眼视力 <0 1者为白内障手术对象。结果　≥ 40岁人群共 1987人 ,1776人接受了检查 ,受检率为 89 3 8%。白内障患病率为 16 5 5 % ,白内障致盲率为 0 84% ,白内障手术负荷量为 2 0 3 %。结论　目前农村白内障致盲率仍较高 ,高质量增加白内障复明手术是防盲治盲的首要任务。     

Causes of blindness and the results of cataract surgical intervention in the Micronesian islands: a retrospective study

Since 1983, we have delivered eye care to inhabitants of the Micronesia islands a total of 18 times over an 18-year period. Approximately 14,000 islanders were examined. We diagnosed a total of 1226 blind eyes and 1231 eyes with low vision. Unoperated cataract (n=765, 62.4%) was the leading cause of blindness in our data, and 611 cataract operations were performed. The preoperative visual acuity of the patients who underwent cataract surgery was less than 20/200. Visual acuity improved in 588 cases (96.2%) after the surgery. Sight-threatening complications occurred in 1.1% (7) of the eyes after the surgery, which is comparable to the rate in developed countries. Corneal opacity secondary to infection (11.2%) was the second leading cause of blindness in our data. Diabetic retinopathy (9.9%) was a cause of low vision in our data, and the number of eyes diagnosed with diabetic retinopathy in each district increased over the years. Glaucoma was the cause of blindness in 1.9% of the blind eyes, although the percentage may actually have been higher because visual loss was assessed only by reduced visual acuity. The demand for correcting refractive errors that caused a visual acuity of less than 20/60, was evident throughout the region. The majority of blind individuals in this study were suffering from operable cataract and good results were obtained with cataract surgery in this region. Further training of local medical staff would significantly improve eye care services in Micronesia.     

我国白内障的流行病学调查资料分析

目的 探讨我国白内障的患病率与各地检查条件、诊断标准及地理环境的关系。方法 采用世界卫生组织盲与低视力标准,对全国抽样调查资料进行统计学分析。结果 双眼视力〈０．３的白内障患者约５００万人,患病率为０．４６％;盲与低视力的患病率分别为０．４３％和０．５８％。盲人中白内障致盲占４１．０６％;低视力患者中４９．３８％为白内障所致;白内障致老年盲（年龄≥６０岁）及低视力占７３．１３％。以晶体混及视力〈０     

A population based eye survey of older adults in Tirunelveli district of south India: blindness, cataract surgery, and visual outcomes

AIMS: To assess the prevalence of vision impairment, blindness, and cataract surgery and to evaluate visual acuity outcomes after cataract surgery in a south Indian population. METHODS: Cluster sampling was used to randomly select a cross sectional sample of people > or =50 years of age living in the Tirunelveli district of south India. Eligible subjects in 28 clusters were enumerated through a door to door household survey. Visual acuity measurements and ocular examinations were performed at a selected site within each of the clusters in early 2000. The principal cause of visual impairment was identified for eyes with presenting visual acuity <6/18. Independent replicate testing for quality assurance monitoring was performed in subjects with reduced vision and in a sample of those with normal vision for six of the study clusters. RESULTS: A total of 5795 people in 3986 households were enumerated and 5411 (93.37%) were examined. The prevalence of presenting and best corrected visual acuity > or =6/18 in both eyes was 59.4% and 75.7%, respectively. Presenting vision <6/60 in both eyes (the definition of blindness in India) was found in 11.0%, and in 4.6% with best correction. Presenting blindness was associated with older age, female sex, and illiteracy. Cataract was the principal cause of blindness in at least one eye in 70.6% of blind people. The prevalence of cataract surgery was 11.8%-with an estimated 56.5% of the cataract blind already operated on. Surgical coverage was inversely associated with illiteracy and with female sex in rural areas. Within the cataract operated sample, 31.7% had presenting visual acuity > or =6/18 in both eyes and 11.8% were <6/60; 40% were bilaterally operated on, with 63% pseudophakic. Presenting vision was <6/60 in 40.7% of aphakic eyes and in 5.1% of pseudophakic eyes; with best correction the percentages were 17.6% and 3.7%, respectively. Refractive error, including uncorrected aphakia, was the main cause of visual impairment in cataract operated eyes. Vision <6/18 was associated with cataract surgery in government, as opposed to that in non-governmental/private facilities. Age, sex, literacy, and area of residence were not predictors of visual outcomes. CONCLUSION: Treatable blindness, particularly that associated with cataract and refractive error, remains a significant problem among older adults in south Indian populations, especially in females, the illiterate, and those living in rural areas. Further study is needed to better understand why a significant proportion of the cataract blind are not taking advantage of free of charge eye care services offered by the Aravind Eye Hospital and others in the district. While continuing to increase cataract surgical volume to reduce blindness, emphasis must also be placed on improving postoperative visual acuity outcomes.     

Visual acuity and binocular vision in children with pseudophakia

PURPOSE: To evaluate the results of cataract surgery in children with IOL implantation. MATERIALS AND METHODS: Our research involved 106 children (156 eyes) with congenital and traumatic cataract, in age from 18 months to 18 years, who underwent cataract surgery with intraocular lens implantation. We evaluated visual acuity for far vision and binocular vision after surgery. RESULTS: Visual acuity over 0.5 in unilateral congenital cataract was found in 27.25%, in traumatic cataract in 73%, whereas in bilateral congenital cataract visual acuity over 0.5 we received in 75% of operated children. Full binocular vision was obtained in children with good visual acuity (0.5 and more), with appropriate alignment of the eyes: 13.1% in unilateral congenital cataract, 45.4% in traumatic cataract and 55% in congenital bilateral cataract. CONCLUSIONS: Cataract surgery with intraocular lens implantation results in increase of visual acuity and in achievement binocular vision, if surgery is carried out in the early period, after it had been diagnosed.     

2009-2013年中国白内障手术患者白内障类型和术前视力分析

目的通过分析2009年7月1日至2013年12月31日期间全国白内障复明手术信息报告系统中手术患者的白内障类型和术前视力,来了解我国白内障类型的构成特点,以及白内障手术适应证掌握情况。方法数据分析。资料来源于全国白内障手术信息报送系统,纳入分析数据5 013 694条。术眼白内障类型根据出院诊断分为年龄相关性、先天性、并发性、外伤性以及未分类的白内障共5种。手术适应证的判断主要为术前矫正视力。对数据采用χ²检验、Spearman 相关进行分析。结果2009-2013年报送的手术信息逐年递增。在接受白内障手术的眼中,以年龄相关性白内障最多,占手术眼总数的90.83%;其次是并发性白内障,占5.40%,外伤性白内障占1.12%,先天性白内障最少,仅占0.80%。接受手术患者≥50岁最多,占93.88%,10～49岁占5.59%,<10岁的患者仅占0.53%。此外,男、女性分别占42.11%和57.89%,女性患者明显多于男性。接受白内障手术的眼大多数是盲眼和低视力眼,分别为46.88%和35.00%。但是18.66%的术眼术前最佳矫正视力≥0.3,特别是7.17%的术眼术前最佳矫正视力≥0.5。结论我国的白内障手术患者以年龄相关性白内障为主。大部分接受白内障手术的眼为盲或低视力眼,但有相当一部分患眼术前矫正视力较好,因此在大规模的白内障复明手术中要严格掌握手术适应证。     

The need for cataract surgery: projections based on lens opacity, visual acuity, and personal concern

AIM: To assess the projected needs for cataract surgery by lens opacity, visual acuity, and patient concern. METHODS: Data were collected as part of the Melbourne Visual Impairment Project, a population based study of age related eye disease in a representative sample of Melbourne residents aged 40 and over. Participants were recruited by a household census and invited to attend a local screening centre. At the study sites, the following data were collected: presenting and best corrected visual acuity, visual fields, intraocular pressure, satisfaction with current vision, personal health history and habits, and a standardised eye examination and photography of the lens and fundus. Lens photographs were graded twice and adjudicated to document lens opacities. Cataract was defined as nuclear greater than or equal to standard 2, 4/16 or greater cortical opacity, or any posterior subcapsular opacities. RESULTS: 3271 (83% response) people living in their own homes were examined. The participants ranged in age from 40 to 98 years and 1511 (46.2%) were men. Previous cataract surgery had been performed in 107 (3.4%) of the participants. The overall prevalence of any type of cataract that had not been surgically corrected was 18%. If the presence of cataract as defined was considered the sole criterion for cataract surgery with no reference to visual acuity, there would be 309 cataract operations per 1000 people aged 40 and over (96 eyes of people who were not satisfied with their vision, 210 eyes of people who were satisfied with their vision, and three previous cataract operations). At a visual acuity criterion of less than 6/12 (the vision required to legally drive a car), 48 cataract operations per 1000 would occur and people would be twice as likely to report dissatisfaction with their vision. CONCLUSIONS: Estimates of the need for cataract surgery vary dramatically by level of lens opacity, visual acuity, and patient concern. These data should be useful for the planning of health services.     

Causes of low vision and blindness in south western Saudi Arabia

The authors studied 1,681 consecutive patients who attended their ophthalmic outpatient clinics over a period of 12 months to determine the patients' visual acuity status and the causes of any visual loss. Using the World Health Organization criteria for definition of visual acuity status, 1004 (59.7%) patients had normal vision. Four hundred and thirty-one (25.6%) patients had low vision or visual impairment and 246 (14.6%) patients were blind. Twenty-eight (1.9%) patients had no light perception in both eyes. Cataract, both in isolation and co-existing with other ocular pathology, was the major cause of both low vision and blindness (58.5% and 81.7%, respectively). A concerted attack on cataract alone will markedly reduce blindness and low vision in this region.     

西北地区眼科单中心1009例单眼盲患者致盲病因和手术疗效分析

目的　分析我国西北地区眼科单中心行白内障手术的单眼盲患者致盲病因和手术效果,为提高防治提供参考。方法　回顾性系列病例研究。纳入2016年7月至2020年11月陕西省眼科医院（西安市第四医院）收治的对侧眼行白内障手术的单眼盲（单眼裸眼视力＜0.05）患者1009例。采用χ²检验及logistic回归分析对患者致盲病因和白内障手术效果进行分析。结果　1009例单眼盲患者中,男465例（46.1%）,女544例（53.9%）,年龄（67.7±11.9）岁。前6种致盲病因分别为青光眼［29.7%（300例）］、视网膜脱离［15.3%（154例）］、眼外伤［14.4%（145例）］、角膜病［6.4%（65例）］、高度近视［6.1%（62例）］、白内障［5.7%（58例）］。对侧眼手术前、后视力完整者989例,术后视力提高者占90.2％（892例）,未提高者占9.8％（97例）;386例单纯白内障患者术后视力均提高,余603例术后视力提高者与未提高者间差异具有统计学意义的相关因素为眼部合并其他疾病及其治疗史(均为P<0.05),进行logistic回归分析后,有意义的独立因素包括青光眼和眼部合并其他疾病治疗史（均为P<0.05）,其中眼部合并其他疾病治疗史回归系数为-2.016,影响最大。结论　青光眼是我国西北地区行白内障手术的单眼盲患者中最常见的致盲病因,且女性多见。单眼盲对侧眼单纯白内障患者在无禁忌证时应尽早行白内障手术。眼部合并疾病尤其青光眼的及时诊治对白内障手术有积极作用。     

Cataract surgical coverage and outcome in the Tibet Autonomous Region of China

BACKGROUND: A recently published, population based survey of the Tibet Autonomous Region (TAR) of China reported on low vision, blindness, and blinding conditions. This paper presents detailed findings from that survey regarding cataract, including prevalence, cataract surgical coverage, surgical outcome, and barriers to use of services. METHODS: The Tibet Eye Care Assessment (TECA) was a prevalence survey of people from randomly selected households from three of the seven provinces of the TAR (Lhoka, Nakchu, and Lingzhr), representing its three main environmental regions. The survey, conducted in 1999 and 2000, assessed visual acuity, cause of vision loss, and eye care services. RESULTS: Among the 15,900 people enumerated, 12,644 were examined (79.6%). Cataract prevalence was 5.2% and 13.8%, for the total population, and those over age 50, respectively. Cataract surgical coverage (vision <6/60) for people age 50 and older (85-90% of cataract blind) was 56% overall, 70% for men and 47% for women. The most common barriers to use of cataract surgical services were distance and cost. In the 216 eyes with cataract surgery, 60% were aphakic and 40% were pseudophakic. Pseudophakic surgery left 19% of eyes blind (<6/60) and an additional 20% of eyes with poor vision (6/24-6/60). Aphakic surgery left 24% of eyes blind and an additional 21% of eyes with poor vision. Even though more women remained blind than men, 28% versus 18% respectively, the different was not statistically significant (p = 0.25). CONCLUSIONS: Cataract surgical coverage was remarkably high despite the difficulty of providing services to such an isolated and sparse population. Cataract surgical outcome was poor for both aphakic and pseudophakic surgery. Two main priorities are improving cataract surgical quality and cataract surgical coverage, particularly for women.