title: Use of cataract surgery in urban Beijing: a post screening follow-up of the elderly with visual impairment due to age-related cataract.
abstract: OBJECTIVE
  To understand the perception for the use of cataract surgical services in a population of acceptors and non-acceptors of cataract surgery in urban Beijing.
  
  
  METHODS
  From a community-based screening program a total of 158 patients with presenting visual acuity of less than 6/18 on either eye due to age-related cataract were informed about the possibility of surgical treatment. These patients were interviewed and re-examined 36 to 46 months after initial screening. The main reasons for not accepting surgery were obtained using a questionnaire. Vision function and vision-related quality of life scores were assessed in those who received and did not receive surgery.
  
  
  RESULTS
  At the follow-up examination 116 of the 158 patients were available and 36 (31.0%) had undergone cataract surgery. Cases who chose surgery had higher education level than those who did not seek surgery (OR=2.64, 95% CI: 1.08-6.63, P=0.02). There were no significant differences in vision function (P=0.11) or quality of life scores (P=0.16) between the surgery group and the non-surgery group. Main reasons for not having surgery included no perceived need (50.0%), feeling of being "too old" (19.2%), and worry about the quality of surgery (9.6%). Cost was cited by 1 (1.9%) subject as the main reason for not seeking surgery.
  
  
  CONCLUSIONS
  The data suggest that in China's capital urban center for patients with moderate visual impairment there is a relative low acceptance rate of cataract surgery, mainly due to people's perception of marginal benefits of surgery. Cost is not a determining factor as barrier to undergo surgery and patients with poorer education are less likely to undertake surgery.
authors.affiliation: Sekwa Eye Hospital, Beijing 100088, China; Epidemiology Unit, Faculty of Science and Technology, Prince of Songkla University, Songkhla 90110, Thailand.
authors.forename: Xue-tao
authors.initials: XT
authors.lastname: Ren
authors.affiliation: Sekwa Eye Hospital, Beijing 100088, China.
authors.forename: Torkel
authors.initials: T
authors.lastname: Snellingen
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Beijing Ophthalmology and Visual Sciences, Beijing 100730, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Gu
authors.affiliation: Epidemiology Unit, Faculty of Science and Technology, Prince of Songkla University, Songkhla 90110, Thailand.
authors.forename: Sawitri
authors.initials: S
authors.lastname: Assanangkornchai
authors.affiliation: Department of Ophthalmology, First Hospital of Tsinghua University, Beijing 100016, China.
authors.forename: Yan-hong
authors.initials: YH
authors.lastname: Zou
authors.affiliation: Epidemiology Unit, Faculty of Science and Technology, Prince of Songkla University, Songkhla 90110, Thailand.
authors.forename: Virasakdi
authors.initials: V
authors.lastname: Chongsuvivatwong
authors.affiliation: Department of Mathematics and Computer Science, Faculty of Science and Technology, Prince of Songkla University, Songkhla 90110, Thailand.
authors.forename: Apiradee
authors.initials: A
authors.lastname: Lim
authors.affiliation: Sekwa Eye Hospital, Beijing 100088, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jia
authors.affiliation: Sekwa Eye Hospital, Beijing 100088, China;Department of Ophthalmology, First Hospital of Tsinghua University, Beijing 100016, China.
authors.forename: Xi-pu
authors.initials: XP
authors.lastname: Liu
authors.affiliation: Sekwa Eye Hospital, Beijing 100088, China; Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Beijing Ophthalmology and Visual Sciences, Beijing 100730, China.
authors.forename: Ning-pu
authors.initials: NP
authors.lastname: Liu
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology*; D000818:Animals; D002386:Cataract / Q000150:complications / Q000503:physiopathology*; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D014505:Urban Population; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology