June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Compliance with Follow-up after Trabeculectomy Surgery in Rural Southern China
Author Affiliations & Notes
  • Ke Yang
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
    Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
  • Ling Jin
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
  • Li LI
    Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
  • Aihua Dan
    Ophthalmology, Red Cross Hospital, Kunming, China
  • Tingting Chen
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
  • Nathan G Congdon
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
    ORBIS International, New York, NY
  • Footnotes
    Commercial Relationships Ke Yang, None; Ling Jin, None; Li LI, None; Aihua Dan, None; Tingting Chen, None; Nathan Congdon, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5017. doi:
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    • Get Citation

      Ke Yang, Ling Jin, Li LI, Aihua Dan, Tingting Chen, Nathan G Congdon; Compliance with Follow-up after Trabeculectomy Surgery in Rural Southern China. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5017.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Glaucoma is the second-leading cause of blindness in China and globally. In rural areas, surgery is the primary treatment, and patient post-operative follow-up is a crucial determinant of surgical success. We sought to evaluate follow-up rates and their determinants in rural southern China.

 
Methods
 

Data on follow up at one week, two weeks, and one month after surgery were obtained from medical records. Patients completed questionnaires providing demographic and socioeconomic information, their transportation status, and knowledge and attitudes about glaucoma, glaucoma surgery and importance of follow-up. Linear regression models were used to assess potential predictors of follow-up.

 
Results
 

Among 212 patients enrolled and completing questionnaires at 14 rural county-level hospitals in Guangdong and Guangxi Provinces (mean age 60.2 +/- 15.2 years, 54.3% women), the post-operative 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. Predictors of poor follow-up (treated as a cumulative score, 10 points at 1 week, 7 points at 2 weeks, 5 points at one month) in multiple regression models included having received no formal education (Beta=-3.04, 95% CI -5.56, -0.52, p=0.022), believing follow-up is less important (Beta=-2.64, 95% CI -4.67, -0.61, P=0.015) and lack of an accompanying friend or family member (Beta=-4.94, 95 CI -5.67, -4.21, P<0.001). Age, sex, employment, transportation, and travel distance, time and costs were not significantly associated with follow-up.

 
Conclusions
 

Only a quarter of rural patients returned a month after glaucoma surgery, at a time when important post-operative interventions affecting outcome (removal of sutures, adjustment of medications, ocular massage) would still be done. Interventions targeting less-educated patients, providing support for return visits and explaining the importance of follow-up are needed.

 
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