title: Inequities in Cataract Surgery and Postsurgical Quality-of-Life Outcomes in Handan, China.
abstract: OBJECTIVE
  This study aimed to describe the rate of cataract surgical coverage (CSC) and the quality-of-life (QoL) outcomes after cataract surgery in rural China.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A clustered, random sampling procedure was used to select 7557 Chinese patients aged 30 years and older from Handan, China. Comprehensive eye examinations, including standardized refraction and classification of lens characteristics, were offered to all eligible subjects. Visual impairment was defined as any individual with presenting visual acuity of less than 20/60 in the better-seeing eye. The main outcome measures were CSC rate and a summary measure assessing QoL in visually impaired (VI) participants.
  
  
  RESULTS
  Of 5592 participants older than 40 years, there were 41 cataract patients operated on and 54 VI cataract patients not operated on. The CSC rate among individuals with VI was 43.2%. Older age was significantly negatively associated with a history of cataract surgery (adjusted odds ratio, 0.44 per 10-year increase in age; 95% confidence interval, 0.26-0.74). Women were less likely to have had cataract surgery compared with men, although not significantly (adjusted odds ratio, 0.44; 95% confidence interval, 0.17-1.12). The QoL summary measure was significantly better in the cataract group operated on than that not operated on (P < 0.01).
  
  
  CONCLUSIONS
  There is a large unmet need for cataract surgery in rural Handan, China. Those who had surgery were more likely to have better QoL outcomes than those who did not. There is a potential need to promote cataract surgery and develop age- and sex-sensitive interventions in rural China.
authors.affiliation: Handan Eye Hospital, Handan City, Hebei Province, China.
authors.forename: Lanping
authors.initials: L
authors.lastname: Sun
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Willes
authors.forename: Yuanbo
authors.initials: Y
authors.lastname: Liang
authors.forename: Dolly S
authors.initials: DS
authors.lastname: Chang
authors.forename: Xinrong
authors.initials: X
authors.lastname: Duan
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Yang
authors.forename: Ningli
authors.initials: N
authors.lastname: Wang
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
keywords: cataract surgery; cataract surgical coverage rate; quality of life; rural China