title: Outcomes of Cataract Surgery in Urban and Rural Population in the South Indian State of Andhra Pradesh: Rapid Assessment of Visual Impairment (RAVI) Project.
abstract: OBJECTIVE
  To assess the visual outcomes after cataract surgery among urban and rural population aged ≥40 years in the South India state of Andhra Pradesh.
  
  
  METHODS
  A population based cross-sectional study was conducted in which 7800 subjects were sampled from two rural and one urban location. Visual Acuity was assessed and eye examination were performed by trained personnel. A questionnaire was used to collect personal and demographic information, and history of cataract surgery. Blindness and moderate Visual Impairment (MVI) was defined as presenting VA <6/60 and <6/18 to 6/60 in the better eye respectively.
  
  
  RESULTS
  In total, 7378 (94.6%) were examined. Of these, 1228 eyes of 870 individuals were operated for cataract. The mean age of operated subjects was 63.7 years (SD: 10.7 years). Overall, 56.3% of those operated were women, 76% were illiterate and 42% of them were using spectacles after cataract surgery. Even after surgery, 12.2% of the operated eyes had MVI and blindness was seen in 14.7% of the eyes. A significantly higher proportion of subjects in urban area had good outcome as compared to those in the rural area (p = 0.01). Uncorrected refractive error (58.7%) was the leading cause of MVI, and posterior segment disease (34.3%) was the leading cause of blindness. On applying multiple logistic regression, risk factors for poor outcomes were age ≥ 70 years (OR: 1.9, 95% CI: 1.3-2.8), rural residence (OR: 1.3, 95% CI:1.0-1.8) and presence of aphakia (OR: 8.9, 95% CI: 5.7-13.8).
  
  
  CONCLUSIONS
  Post cataract surgery, refractive errors remain an important correctable cause of MVI, in the south Indian state of Andhra Pradesh. The correction of refractive errors is required to provide good visual recovery and achieve the benefit of cataract surgery.
authors.affiliation: Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India.|Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India.|Wellcome Trust / Department of Biotechnology India Alliance Research Fellow, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Marmamula
authors.affiliation: Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India.|Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Rohit C
authors.initials: RC
authors.lastname: Khanna
authors.affiliation: Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Konegari
authors.initials: K
authors.lastname: Shekhar
authors.affiliation: Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India.|Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Gullapalli N
authors.initials: GN
authors.lastname: Rao
mesh_terms: D000368:Aged; D001766:Blindness / Q000601:surgery; D002386:Cataract / Q000503:physiopathology* / Q000628:therapy*; D002387:Cataract Extraction / Q000379:methods; D003430:Cross-Sectional Studies; D005139:Eyeglasses; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D012030:Refractive Errors / Q000503:physiopathology / Q000628:therapy; D012424:Rural Population; D014505:Urban Population; D015354:Vision, Low / Q000601:surgery; D014792:Visual Acuity / Q000502:physiology*