Prevalence and service assessment of cataract in Tibetan areas of Sichuan Province, China: population-based study.

OBJECTIVES: To assess the prevalence of visual impairment (VI) and blindness (BL) due to cataract and cataract surgical outcomes in remote dispersed and high-altitude Tibetan areas of China. DESIGN AND SETTING: A cross-sectional study was conducted among people aged 50 and above in Tibetan Autonomous Prefecture of Kandze (TAPK), China, in 2017. The Rapid Assessment of Avoidable Blindness protocol was followed. PARTICIPANTS: Of 5000 eligible participants, 4764 were examined (response rate 95.3%). PRIMARY AND SECONDARY OUTCOME MEASURES: Cataract VI was defined as lens opacity at visual acuity (VA) levels of <3/60 (Blindness (BL)), ≥3/60 and <6/60 (severe visual impairment (SVI)), ≥6/60 and <6/18 (moderate visual impairment (MVI)), ≥6/18 and <6/12 (early visual impairment (EVI)). RESULTS: The estimated prevalence of cataract BL was 0.61% (95% CI 0.42 to 0.87). With best corrected VA, the estimated prevalence of SVI from cataract was 0.86% (95% CI 0.63 to 1.17); MVI was 2.39% (95% CI 2.00 to 2.87) and EVI was 5.21% (95% CI 4.61 to 5.87). Women in TAPK had a significantly higher prevalence of cataract BL (0.82%, 95% CI 0.54 to 2.15) than men (0.34%, 95% CI 0.16 to 0.70). Women had lower cataract surgical coverage (CSC) by eyes (60.8%, 95% CI 55.5 to 65.8) compared with men (70.1%; 95% CI 63.7 to 75.7). The prevalence of cataract BL was higher among Tibetan (2.28%; 95% CI 1.98 to 2.62) than Han Chinese (1.01%%; 95% CI 0.54% to 1.87%). Overall CSC by person with BL (by better eye) was 82.0% (95% CI 75.2 to 87.6). Among cataract-operated participants, 71.2% had VA equal to or better than 6/18. CONCLUSIONS: The study detected a low prevalence of VI and BL due to cataract with high CSC in the study area compared with many other places in China. Further actions should be taken to improve cataract surgical outcome

Predictors of long-term cataract surgical patient satisfaction found in cell-phone follow-up in a primarily Tibetan region of China

AIM:To evaluate predictors of patient satisfaction with vision and comfort following cataract surgery in Kandze Prefecture People's Hospital, in Dartsedo, the capital of a Tibetan region of China.<p>METHODS:Prospective observational study of all patients undergoing cataract surgery in Kandze Hospital in 2012. Patients categorized in terms of ocular pathology and/or surgical complications at discharge, were contacted at 3mo postoperatively by cell-phone to determine satisfaction with vision and presence of discomfort.<p>RESULTS:In 2012, Kandze Hospital conducted 888 cataract operations on 678 patients, 364(54%)women. Most patients(93%)presented with severe visual impairment or blindness(<6/60)in the better eye. Among the 881 eyes, the main surgical complications were corneal edema(44 cases)and vitreous loss(19 cases)while the main pathologies were retinal disorders(30 cases)and “old” iritis(11 cases). At 3mo, 508(75% of 678 cataract patients)were contacted at least once by cell-phone. Of the 588 eyes self-assessed, 485(82%)were reported “better”, 85(15%)“same”, and 18(3%)“worse” than the time of discharge for discomfort, visual acuity, or both. Significantly more eyes “with pathology” compared with “neither pathology nor complications” at discharge were reported to have discomfort or poor vision at 3mo(Chi-square=6.575, <i>P</i>=0.037).<p>CONCLUSION:The need forcataract surgical patient follow-up advice at 3mo is predictable at discharge and increasingly possible with cell-phone technology. However, the ability to assist patients with complications or ocular pathology depends on improving eye care services in the region