title: Preoperative characteristics and compliance with follow-up after trabeculectomy surgery in rural southern China.
abstract: To evaluate preoperative characteristics and follow-up in rural China after trabeculectomy, the primary treatment for glaucoma there.
  
  
  
  Patients undergoing trabeculectomy at 14 rural hospitals in Guangdong and Guangxi Provinces and their doctors completed questionnaires concerning clinical and sociodemographic information, transportation, and knowledge and attitudes about glaucoma. Follow-up after surgery was assessed as cumulative score (1 week: 10 points, 2 weeks: 7 points, 1 month: 5 points).
  
  
  
  Among 212 eligible patients, mean preoperative presenting acuity in the operative eye was 6/120, with 61.3% (n=130) blind (≤6/60). Follow-up rates were 60.8% (129/212), 75.9% (161/212) and 26.9% (57/212) at 1 week, 2 weeks and 1 month, respectively. Patient predictors of poor follow-up included elementary education or less (OR=0.37, 95% CI 0.20 to 0.70, p=0.002), believing follow-up was not important (OR=0.62, 95% CI 0.41 to 0.94, p=0.02), lack of an accompanying person (OR=0.14, 95% CI 0.07 to 0.29, p<0.001), family annual income <US$800 (OR=0.28, 95% CI 0.11 to 0.72, p=0.008) and not requiring removal of scleral flap sutures postoperatively (OR=0.11, 95% CI 0.06 to 0.22, p<0.001). Age, sex, employment, travel distance/time/costs, patient preoperative clinical factors and physician factors were unassociated with follow-up.
  
  
  
  Follow-up after 2 weeks was inadequate to provide optimal clinical care, and surgery is being applied too late to avoid blindness in the majority of patients. Earlier surgery, support for return visits and better explanations of the importance of follow-up are needed. Directing all patients to return for possible scleral flap suture removal may be a valid strategy to improve follow-up.
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.|Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Yang
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Jin
authors.affiliation: Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
authors.forename: Siming
authors.initials: S
authors.lastname: Zeng
authors.affiliation: Red Cross Hospital of Yunnan Province, Kunming, China.
authors.forename: Aihua
authors.initials: A
authors.lastname: Dan
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.|Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, China.
authors.forename: Xiuqin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
authors.forename: Guirong
authors.initials: G
authors.lastname: Li
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.|ORBIS International, New York, USA.|Queen's University Belfast, Belfast, UK.
authors.forename: Nathan
authors.initials: N
authors.lastname: Congdon
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007429:Intraocular Pressure; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014130:Trabeculectomy / Q000706:statistics & numerical data*; D014792:Visual Acuity
keywords: Epidemiology; Glaucoma