Population based outcomes of cataract surgery in three tribal areas of Andhra Pradesh, India: risk factors for poor outcomes.
Population based outcomes of cataract surgery in three tribal areas of Andhra Pradesh, India: risk factors for poor outcomes.
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DOI：
10.1371/journal.pone.0035701
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Schein OD
中科院分区：
文献类型：
--
作者：
Khanna RC;Pallerla SR;Eeda SS;Gudapati BK;Cassard SD;Rani PK;Shantha GP;Chakrabarti S;Schein OD
报告印度安得拉邦三个综合部落发展署(ITDA)地区白内障手术的视力结果和不良预后的风险因素。使用有效的可避免失明快速评估(RAAB)方法，在ITDA的三个地区进行了一项基于人群的横断面研究。采用两阶段抽样方法，抽取7281名年龄在50岁及以上的调查对象。使用翻滚E表进行视力评估，并进行标准眼科检查。对接受白内障手术的受试者(1124名受试者的1548只眼)的视力结果和不良结果的危险因素进行了评估。手术时平均年龄67±8岁，术后视力低于6/18者492眼(31.8%；95%CI，29.5~34.2%)，298眼(19.3%；95%CI，17.3%~21.3%)。PVA和BCVA低于6/60者分别为219眼(14.1%；95%CI，12.4~16%)和147眼(9.5%；95%CI，8.1~11.1%)。双眼PVA和BCVA均低于6/18者分别为323例(20.1%；95%CI，18.9~23%)和144例(9.3%；95%CI，7.9~10.9%)。PVA和BCVA低于6/60者分别为74例(4.8%；95%CI，3.8~6%)和49例(3.2%；95%CI，2.4~4.2%)。1316只人工晶状体眼中有51只眼后囊混浊(3.9%；95%CI，2.9-5.1%)。在多因素分析中，PVA大于6/18的人工晶状体眼患者中，年龄增大(p = 0.002)和接受免费手术(p = 0.05)是独立危险因素。2005年以前做过手术(p = 0.05)和文盲(p = 0.05)是视力低于6/18的独立危险因素。在印度这些部落人口中，随着白内障手术结果的改善，有变化的趋势。然而，术后屈光不正仍然是一个问题，特别是对那些接受免费手术的人。
To report visual outcomes and risk factors for poor outcomes of cataract surgery in three Integrated Tribal Development Agency (ITDA) areas of Andhra Pradesh, India. Using validated Rapid Assessment of Avoidable Blindness (RAAB) methodology, a population based cross-sectional study, was conducted in three ITDA areas. A two-stage sampling procedure was used to select 7281 participants aged 50 years and above. Vision assessment using a tumbling E chart and standard ocular examinations were completed. Visual outcomes and risk factors for poor outcomes were assessed among subjects undergoing cataract surgery (1548 eyes of 1124 subjects). Mean age at surgery was 67±8 years; Among the operated eyes, presenting visual acuity (PVA) and best corrected visual acuity (BCVA) worse than 6/18 was seen in 492 (31.8%; 95% CI, 29.5–34.2%) and 298 eyes (19.3%; 95% CI, 17.3–21.3%), respectively. Similarly, PVA and BCVA worse than 6/60 was seen in 219 (14.1%; 95% CI, 12.4–16%) and 147 eyes (9.5%; 95% CI, 8.1–11.1%), respectively. When either eye was taken into consideration, the PVA and BCVA worse than 6/18 was seen in 323 (20.1%; 95% CI, 18.9–23%) and 144 subjects (9.3%; 95% CI, 7.9–10.9%), respectively. PVA and BCVA worse than 6/60 was seen in 74 (4.8%; 95% CI, 3.8–6%) and 49 subjects (3.2%; 95% CI, 2.4–4.2%), respectively. Posterior capsular opacification was seen in 51 of 1316 pseudophakic eyes (3.9%; 95% CI, 2.9–5.1%). In multivariable analysis among pseudophakic subjects with PVA worse than 6/18, increasing age (p = 0.002) and undergoing free surgery (p = 0.05) were independent risk factors. Undergoing surgery before 2005 (p = 0.05) and being illiterate (p = 0.05) were independent risk factors for BCVA worse than 6/18. There are changing trends with improved outcomes in cataract surgery among these tribal populations of India. However, post-operative refractive error correction remains an issue, especially for those undergoing free surgeries.
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