Distribution and visual impact of postoperative refractive error after cataract surgery in rural China: study of cataract outcomes and up-take of services report 4.
OBJECTIVE
To model the possible impact of using average-power intraocular lenses (IOLs) and evaluate the postoperative refractive error in patients having cataract surgery in rural China.


METHODS
Rural Guangdong, China.


METHODS
Patients having cataract surgery by local surgeons were examined and visual function was assessed 10 to 14 months after surgery. Subjective refraction at near and distance was performed bilaterally by an ophthalmologist. Patients had a target refraction of -0.50 diopter (D) based on ocular biometry.


RESULTS
Of the 313 eligible patients, 242 (77%) could be contacted and 176 (74% of contacted patients, 56% overall) were examined. Examined patients had a mean age of 69.4 +/- 10.5 years. Of the 211 operated eyes, 73.2% were within +/-1.0 D of the target refraction after surgery. The best presenting distance vision was in patients within +/-1.0 D of plano and the best presenting near vision, in those with mild myopia (<-1.0 D to > or =2.0 D) (P= .005). However, patients with hyperopia (>+1.0 D) reported significantly better adjusted visual function than those with emmetropia or myopia (<-1.0 D). When the predicted use of an average-power IOL (median +21.5 D) was modeled, predicted visual acuity was significantly reduced (P= .001); however, predicted visual function was not significantly altered (P>.3).


CONCLUSIONS
Accurate selection of postoperative refractive error was achieved by local surgeons in this rural area. Based on visual function results, aiming for mild postoperative myopia may not be suitable in this setting. Implanting average-power IOLs significantly reduced postoperative presenting vision, but not visual function.
Joint Shantou International Eye Center, Shantou University and Chinese University of Hong Kong, Shantou, Guangdong, China. zzx@jsiec.org
Zhongxia
Z
Zhou
Nathan G
NG
Congdon
Mingzhi
M
Zhang
Lijia
L
Chen
Zhongren
Z
Zheng
Lishan
L
Zhang
Xiaofang
X
Lin
Lijuan
L
He
Kai
K
Choi
Dennis S C
DS
Lam
D000368:Aged; D001699:Biometry; D002387:Cataract Extraction; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D015233:Models, Statistical; D009216:Myopia / Q000503:physiopathology*; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications; D012029:Refraction, Ocular; D012424:Rural Population / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*