Prevalence and vision-related outcomes of cataract surgery in Gujarat, India.
OBJECTIVE
Investigate the prevalence and vision-related outcomes of cataract surgery in an area of high cataract surgical rate.


METHODS
Cluster sampling was used in randomly selecting individuals > or = 50 years of age in 2007. Participants were queried regarding year and place of previous cataract surgery. Cataract surgical procedures and evidence of surgical complications were recorded. The principal cause was identified for eyes presenting with visual acuity (VA) < or = 20/40.


RESULTS
A total of 4,738 persons were examined and 834 (17.6%) had cataract surgery. Intra-ocular lenses (IOLs) were used in 84.1% of the 1,299 cataract-operated eyes, with more than half of these having manual small incision surgery. Surgical coverage among the cataract blind (visual acuity [VA] < 20/200) was estimated as 72.2%. Coverage was associated with older age, literacy, and urban residence; gender was not significant. Among cataract-operated eyes, 18.7% presented with VA > or = 20/32 and 18.0% were < 20/200. With best-corrected acuity, the corresponding percentages were 55.7% and 11.0%. Presenting and best-corrected VA > or = 20/63 were associated with young age, literacy, and IOL surgery; urban residence and surgery in non-governmental organizations (NGO)/private facilities were also significant for presenting VA; and recent surgery was significant for best-corrected VA. Refractive error was the main cause of vision impairment/blindness in cataract-operated eyes.


CONCLUSIONS
Refractive error and posterior capsule opacification, easily treatable causes of visual impairment, are common among the operated. A greater emphasis on the quality of visual acuity outcomes along with sustained efforts to provide access to affordable surgery is needed.
Murthy
Gudlavalleti V S
GV
International Center for Eye Health, London School of Hygiene & Tropical Medicine, London, UK. gvsmurthy2000@yahoo.com
Vashist
Praveen
P
John
Neena
N
Pokharel
Gopal
G
Ellwein
Leon B
LB
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000453:epidemiology* / Q000503:physiopathology; D002387:Cataract Extraction / Q000379:methods / Q000706:statistics & numerical data*; D016000:Cluster Analysis; D004522:Educational Status; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012030:Refractive Errors / Q000453:epidemiology; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D016896:Treatment Outcome; D014505:Urban Population / Q000706:statistics & numerical data; D014792:Visual Acuity / Q000502:physiology*