西部四地50岁以上农村人口年龄相关性白内障手术状况调查

目的 调查我国西部省份青海、云南、贵州和广西50岁及以上农村人口的白内障手术率、手术覆盖率和术后效果.方法 以自然村为抽样单位采用整群抽样方法 抽取年龄≥50岁的农业人口共5562人(青海平安1486人;云南楚雄1494人;贵州六盘水1238人;广西崇左1344人),进行系统的眼科检查和问卷调查.以较好视力眼低于0.1的白内障患者为纳入标准计算白内障手术覆盖率,同时计算白内障手术率(CSR)并分析术后效果.结果 青海平安的白内障手术覆盖率最高为54%,其他3个地区分别为41%、36%和39%;贵州和广西的男性白内障手术覆盖率明显高于女性,青海和云南的白内障手术覆盖率的性别差异无统计学意义.2000-2002年期间青海平安的CSR值最高为1551,其他3个地区的CSR值均在800以下.4个不同人群白内障手术眼的总体人工晶体植入率51.5%,术后视力低于0.1者为40.5%,术后并发症发生率28%.结论 我国西部地区50岁以上人群的白内障手术覆盖率和CSR值较低,同时,术后视力不良的情况较严重.提示在积极增加白内障手术数量的同时,应不断提高白内障手术质量.

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

Objective 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. Methods This crnss-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. Results Of individuals whit 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%. Conclusion 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.