PREVALENCE AND OUTCOMES OF CATARACT SURGERY IN AN URBAN CENSUS SECTOR OF PARINTINS, BRAZILIAN AMAZON REGION

Abstract

Purpose: To investigate the prevalence and visual acuity outcomes of cataract surgery in older adults in an urban census sector of Parintins, Brazil.

Methods: An urban census sector was conveniently chosen for its proximity to the eye clinic for ophthalmic assessment. Subjects were enumerated through a door-to-door survey and those with ages 45 years and older were invited for ophthalmic assessment. Participants were queried as to the year and type of facility for previous cataract surgery. Surgical procedure and evidence of surgery complications were noted. Main outcome measures were presented and best-corrected vision, and the principal cause for eyes presenting with VA <20/40 was identified.

Results: A total of 178 eligible persons in 136 households were enumerated, and 144 (80.9%) were examined. The prevalence of cataract surgery was 19.44% (95% confidence interval [CI]: 13.3% - 26.9%). Among the 46 (16.0% - 95% CI - 11.9% - 20.7%) operated eyes, 52.2% presented with VA >20/40, 4.4% with VA 20/40 to 20/63, 21.7% with VA <20/63 to 20/200 and 21.7% with VA <20/200. With best correction, the percentages were 60.9%, 2.2%, 19.6% and 17.4% respectively. Intraocular lenses were found in 89.1% of cataract-operated eyes; 71.7% appeared to have been operated by phacoemulsification. Uncorrected refractive error and corneal opacities were the main causes of vision impairment/blindness in operated eyes.

Conclusions: In a small urban census sector of the Brazilian Amazon region, the prevalence of cataract surgery was substantially higher when compared to other urban areas of Brazil. Cataract surgery campaigns implemented in the last 10 years in that area had provided access to this population in remote area of the Amazon. Uncorrected refractive errors and other causes of impairment were common in cataract-operated eyes. Emphasis on the quality of VA outcomes is needed.

Keywords: 445 cataract • 462 clinical (human) or epidemiologic studies: outcomes/complications • 463 clinical (human) or epidemiologic studies: prevalence/incidence