Cataract as a Cause of Blindness and Vision Impairment in Latin America: Progress Made and Challenges Beyond 2020
Cataract as a Cause of Blindness and Vision Impairment in Latin America: Progress Made and Challenges Beyond 2020
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DOI：
10.1016/j.ajo.2020.12.022
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发表时间：
2021-02-27
影响因子：
4.2
通讯作者：
Furtado，J. O. A. M.
中科院分区：
文献类型：
--
作者：
Reis，Tulio;Lansingh，Van;Furtado，J. O. A. M.
PurposeTo provide a update of cataract as a cause of vision loss in Latin America and to analyze sex inequalities in cataract surgery coverage（CSC）and effective CSC（eCSC）in the region.DesignPopulation-based systematic review with longitudinal comparisons.MethodsThe Latin American and Caribbean Health Sciences Literature（LILACS）and PubMed databased were searched for population-based studies reporting cataract blindness，surgery coverage，以及2014年1月至2019年12月期间发布的结果。从卫生部获得了2014-2016年期间进行的手术数量信息，并用于计算白内障手术率（CSR）。来源，如快速评估的避盲（RAAB）和快速评估的白内障手术服务的数据进行了重新分析，以计算CSC和eCSC的性别不平等，通过减去妇女的速度在mesen.ResultsCataract是29.8%-77.6%的失明病例的原因，在纳入的研究中，CSR改善了10个国家。CSC 3/60的针孔视力从秘鲁的24.1%到阿根廷的97.1%不等，CSC 3/60的绝对性别不平等中位数为-0.7%。eCSC针孔视力3/60从危地马拉的14.8%到阿根廷的92.1%不等，eCSC针孔视力3/60的绝对性别不平等中位数为-0.8%.ConclusionsCataract仍然是拉丁美洲失明的主要原因。在许多国家，覆盖面不够理想，手术效果也低于目标水平。鼓励更好地分配人力资源，对眼科医生进行充分培训，并将视力服务纳入全民医疗保健覆盖范围，可以减轻拉丁美洲白内障的负担。
PurposeTo provide an update of cataract as a cause of vision loss in Latin America and to analyze sex inequalities in cataract surgical coverage (CSC) and effective CSC (eCSC) in the region.DesignPopulation-based systematic review with longitudinal comparisons.MethodsThe Latin American and Caribbean Health Sciences Literature (LILACS) and PubMed databased were searched for population-based studies reporting cataract blindness, surgical coverage, and outcomes published between January 2014 and December 2019. Information on the number of surgeries performed from the 2014-2016 period was obtained from ministries of health and was used for calculation of the cataract surgical rate (CSR). Sources such as Rapid Assessment of Avoidable Blindness (RAAB) and Rapid Assessment of Cataract Surgical Services data were reanalyzed to calculate sex inequality in CSC and eCSC by subtracting the rate in women from the rate in men.ResultsCataract was the cause of 29.8%-77.6% of cases of blindness in the included studies; the CSR improved in 10 countries. The CSC pinhole visual acuity of 3/60 varied from 24.1% in Peru to 97.1% in Argentina, and the median absolute gender inequality CSC pinhole visual acuity 3/60 was −0.7%. The eCSC pinhole visual acuity 3/60 varied from 14.8% in Guatemala to 92.1% in Argentina, and the median absolute gender inequality eCSC pinhole visual acuity 3/60 was −0.8%.ConclusionsCataract remains a leading cause of blindness in Latin America. Coverage is suboptimal, and surgical results are also below target levels in many countries. Incentives for a better distribution of human resources, adequate training of ophthalmologists, and the inclusion of vision services in universal health care coverage could reduce the burden of cataract in Latin America.