title: Visual function and postoperative care after cataract surgery in rural China: study of cataract outcomes and up-take of services (SCOUTS) in the caring is hip project, report 2.
abstract: OBJECTIVE
  To study the postoperative visual function and uptake of refraction and second-eye surgery among persons undergoing cataract surgery in rural China.
  
  
  METHODS
  Self-reported visual function was measured 10 to 14 months after surgery. Subjects with improvement of 2 or more lines with refraction were offered glasses, and those with significant cataract were offered second-eye surgery.
  
  
  RESULTS
  Among 313 eligible subjects, 242 (77%) could be contacted; 176 (73%) of those contacted were examined. Interviewed subjects had a mean +/- SD age of 69.9 +/- 10.2 years, and 63.6% were female. The mean +/- SD visual function score was 88.4 +/- 12.3, higher than previously reported for cataract programs in rural China and significantly (P = .03) correlated with presenting vision. Forty-two percent of subjects had spectacles, more than half being reading glasses. Though 87% of subjects' vision improved with refraction, only 35% accepted prescriptions, the most common reason for refusal being lack of perceived need. Second-eye surgery was accepted by a total of 48% (85 of 176) of patients, cost being the biggest reason for refusal.
  
  
  CONCLUSIONS
  Visual function was high in this cohort. Potential benefit of refraction and second-eye surgery was substantial, but uptake of services was modest. Programs to improve service uptake should focus on reading glasses and cost-reduction strategies such as tiered pricing.
authors.affiliation: Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital 3/F, 147K Argyle St, Kowloon, Hong Kong, China. ncongdon@cuhk.edu.hk
authors.forename: Nathan G
authors.initials: NG
authors.lastname: Congdon
authors.forename: Srinivas K
authors.initials: SK
authors.lastname: Rao
authors.forename: Xiaqing
authors.initials: X
authors.lastname: Zhao
authors.forename: Weizhao
authors.initials: W
authors.lastname: Wang
authors.forename: Kai
authors.initials: K
authors.lastname: Choi
authors.forename: Dennis S C
authors.initials: DS
authors.lastname: Lam
mesh_terms: D000368:Aged; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D011182:Postoperative Care; D012029:Refraction, Ocular; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*