A population-based eye survey of older adults in a rural district of Rajasthan: II. Outcomes of cataract surgery


Murthy, GV; Ellwein, LB; Gupta, S; Tanikachalam, K; Ray, M; Dada, VK; (2001) A population-based eye survey of older adults in a rural district of Rajasthan: II. Outcomes of cataract surgery. Ophthalmology, 108 (4). pp. 686-92. ISSN 0161-6420 DOI: https://doi.org/10.1016/S0161-6420(00)00578-9

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Abstract

PURPOSE: To assess the outcomes of cataract surgery in rural northwest India. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 549 cataract-operated persons (723 operated eyes). METHODS: Cluster sampling was used in randomly selecting a cross-sectional sample of persons 50 years of age or older for visual acuity measurement, refraction, and slit-lamp and direct ophthalmoscope examination early in 1999. Those operated on for cataract were queried as to the date and place of surgery. The principal cause of reduced vision was identified for all examined eyes with presenting visual acuity worse than 6/18. MAIN OUTCOME MEASURES: Presenting and best-corrected visual acuity and cause of vision loss. RESULTS: Presenting visual acuity was less than 6/60 in the better eye in 33.7% of cataract-operated persons and greater than or equal to 6/18 in both eyes in 8.2%; 31.7% were bilaterally operated on. Of cataract-operated eyes, 44.1% initially had visual acuity less than 6/60 and 31.5% greater than or equal to 6/18; with best correction, the corresponding percentages were 14.0% and 61.5%. Intracapsular cataract extraction was used in 92% of cases, and 66% had been operated on in surgery camps. Surgical complications were common and a major cause of vision impairment. In multiple logistic regression modeling, female gender and residence in a rural area were associated negatively with both presenting and best-corrected visual acuity outcomes, and surgery conducted before 1990 was associated negatively with best-corrected visual acuity. Place of surgery and subject schooling were not associated with vision outcomes. CONCLUSIONS: Cataract surgery subjects in rural areas of India that are without adequately equipped facilities and skilled surgeons, and lack of availability of intraocular lenses, are not realizing the full sight-restoring potential of modern-day surgery. Emphasis on the quality of cataract surgery outcomes must be increased to keep pace with that being given to increasing surgical volume.

Item Type: Article
Keywords: Aged, Aged, 80 and over, Cataract, Cataract Extraction, Cluster Analysis, Cross-Sectional Studies, Female, Health Surveys, Humans, India, Intraoperative Complications, Lens Implantation, Intraocular, Male, Middle Aged, Outcome Assessment (Health Care), Postoperative Complications, Refraction, Ocular, Rural Population, Visual Acuity, Aged, Aged, 80 and over, Cataract, complications, epidemiology, Cataract Extraction, statistics & numerical data, Cluster Analysis, Cross-Sectional Studies, Female, Health Surveys, Humans, India, epidemiology, Intraoperative Complications, epidemiology, Lens Implantation, Intraocular, statistics & numerical data, Male, Middle Aged, Outcome Assessment (Health Care), Postoperative Complications, epidemiology, Refraction, Ocular, Rural Population, statistics & numerical data, Visual Acuity
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: The International Centre for Evidence in Disability
International Centre for Eye Health
PubMed ID: 11297484
Web of Science ID: 167749400027
URI: http://researchonline.lshtm.ac.uk/id/eprint/8786

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