title: Prevalence and outcomes of cataract surgery in adult rural Chinese populations of the Bai nationality in Dali: the Yunnan minority eye study.
abstract: OBJECTIVE
  To investigate the prevalence and visual acuity (VA) outcomes of cataract surgery in adults of the Bai Nationality populations in rural China.
  
  
  METHODS
  We conducted a population-based cross-sectional survey (from randomly selected block groups) of Chinese Bai Nationality aged ≥50 years in southwestern China. Presenting visual acuity (PVA), best corrected visual acuity (BCVA) were recorded and a detailed eye examination was carried out. For all aphakic and pseudophakic subjects identified, information on the date, setting, type, and complications of cataract surgery were recorded. In eyes with VA <20/63, the principal cause of visual impairment was identified.
  
  
  RESULTS
  Of 2133 (77.8% of 2742) subjects, 99 people (129 eyes) had undergone cataract surgery. The prevalence of cataract surgery was 4.6%. Surgical coverage among those with PVA <20/200 in both eyes because of cataract was 52.8%. Unoperated cataract was associated with older age. The main barrier to cataract surgery was lack of awareness and knowledge, cost, and fear. Among the 129 cataract-operated eyes, 22.5% had PVA of ≥20/32, 25.6% had PVA of 20/40 to 20/63, 23.3% had PVA <20/63 to 20/200, and 28.7% had PVA<20/200. With BCVA, the percentages were 42.6%, 23.3%, 10.9%, and 23.3%, respectively. Aphakia (odds ratio [OR], 8.49; P<0.001) and no education (OR, 10.18; P = 0.001) or less education (OR, 6.49; P = 0.014) were significantly associated with postoperative visual impairment defined by PVA, while aphakia (OR, 8.49; P<0.001) and female gender (OR, 4.19; P = 0.004) were significantly associated with postoperative visual impairment by BCVA. The main causes of postoperative visual impairment were refractive error, retinal disorders and glaucoma.
  
  
  CONCLUSIONS
  Half of those with bilateral visual impairment or blindness because of cataract remain in need of cataract surgery in Bai population. Surgical uptake and visual outcomes should be further improved in the future.
authors.affiliation: The First Affiliated Hospital of Kunming Medical University, Kunming, China ; Yunnan Red Cross Hospital, Kunming, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Shen
authors.forename: Yongming
authors.initials: Y
authors.lastname: Yang
authors.forename: Minbin
authors.initials: M
authors.lastname: Yu
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Tao
authors.initials: T
authors.lastname: Wei
authors.forename: Xun
authors.initials: X
authors.lastname: Li
authors.forename: Juanjuan
authors.initials: J
authors.lastname: Li
authors.forename: Xiaodan
authors.initials: X
authors.lastname: Su
authors.forename: Hua
authors.initials: H
authors.lastname: Zhong
authors.forename: Yuansheng
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology*; D002386:Cataract / Q000453:epidemiology* / Q000503:physiopathology; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005123:Eye / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014792:Visual Acuity