Abstract
Purpose: :
The recently-completed "Million Cataract Surgeries Program (MCSP)" in China is one of the largest single cataract surgical campaigns recorded, providing operations for a million patients in largely rural areas of China from 2009 to 2011. We report for the first time surgical outcomes and impact of this program, in Jiangxi Province, where the largest number of operations was performed.
Methods: :
Ten government, county-level hospitals participating in the MCSP were selected to represent a broad range of economic conditions in Jiangxi Province (mean county personal income 322 to 747 USD). All of these hospitals had received training from an Australian-based NGO, as had 64 (71.1%) of 90 county facilities in the province. Seventy-five consecutive patients operated under MCSP and aged >= 50 years were enrolled at each center. Data recorded included: type of surgical procedure (manual small-incision [SICS], ECCE, phaco), surgical complications, un-corrected and best-corrected visual acuity (UCVA, BCVA) and refractive error for both eyes pre and >= 50 days post-operatively.
Results: :
Among 715 enrolled subjects (mean age 72.3±9.2 years, 55.8% female, and pre-operative UCVA was < 3/60 bilaterally in 14.9% and unilaterally in 64.2%. SICS was performed in 92.4% of cases. Among 661 (92.4%) patients with follow-up, BCVA was ≥ 6/18 in 80.3%, UCVA was ≥ 6/18 in 57.2% and both BCVA and UCVA were < 3/60 in 2.0%. Among persons with UCVA < 6/18, 132 (38.0%) could achieve visual acuity ≥ 6/18 after correction. In regression models, older age (P < 0.001), worse refractive error (P < 0.001) and post operative complications (P = 0.04) were associated with UCVA < 6/18.
Conclusions: :
Assuming these results from Jiangxi are representative, among one million patients operated nationally in MCSP, 146,000 persons were cured of bilateral blindness and 629,000 of unilateral blindness.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • cataract