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。

Types of cataract and the preoperative visual acuity of surgerical patients in China in 2009-2013

ObjectiveTo acquire the composing features of cataract types in China and the knowledge of surgical indications by analyzing the cataract types and preoperative visual acuities of cataract surgical patients nationwide from July 1st，2009 to December 31st， 2013， for promoting the large-scale cataract-extraction work in China. MethodsThe data comes from the national cataract surgery information reporting system， including 5 013 694 items. Based on the discharge diagnosis， there are five cataract types of operative eyes， including senile cataract， congenital cataract， complicated cataract， traumatic cataract and unclassified cataract. The judgment on surgical indications is made mainly according to the preoperative corrective visual acuity. SAS 9.2 is used for the statistical analysis， with categorical data of Chi-square test and Spearman correlation analysis. ResultsThe surgery information reported increases yearly from 2009 to 2013. Among all the operative eyes， senile cataract was the dominant type （90.83%）； complicated cataract ranked the second （5.40%）； traumatic cataract accounted for 1.12%； the least was congenital cataract （0.80%）. In terms of the age at operation， the age group of 50 years and over was the dominant one （93.88%）； 10 years to 49 years （5.59%） followed； under the age of 10（0.53%） was least. In terms of the gender at operation， the number of female patients exceeded the male， accounting for 57.89% and 42.11% respectively. Most of the operative eyes for cataract were blind （46.88%） or low vision （35.00%）. While 18.66% of the preoperative best corrected visual acuity was 0.3 and below， and 7.17% was 0.5 and below. ConclusionThe senile cataract was the dominant type among all the cataract surgery patients in China. Most of the operative eyes were blind or low vision， while a significant number of patients had good preoperative corrective visual acuities. Therefore the surgical indications should be mastered strictly during performing the large-scale cataract surgeries.