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M. R. Mitsuhiro, A. Berezovsky, R. Belfort, Jr., S. R. Salomão; Cataract Surgery Compliance in Low-Income Older Adults in Brazil: The São Paulo Eye Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4551.
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© ARVO (1962-2015); The Authors (2016-present)
To determine cataract surgery indication and compliance in a low-middle income population in São Paulo, Brazil.
The São Paulo Eye Study (SPES) was a population-based study of urban, low-middle income residents of three districts of São Paulo city. A door-to-door household census was conducted to identify residents aged 50 years and older from 22 randomly selected clusters. The study was carried out from July 2004 to December 2005. Briefly, 3768 participants were recruited and had an eye exam including visual acuity (VA) measurement, refraction, and slit-lamp examination. Cataract surgery was indicated and offered free-of-charge at our local hospital for those who had cataract as a principal cause of best-corrected VA ≤ 20/40 in either eye. Two years after the original study, a household survey was performed to identify compliance to cataract surgery indication.
From the original 3,678 participants, 218 (5.93%) had cataract surgery indication. In a two-year follow-up, 167 participants were successfully contacted (76.6%), 36 participants had passed away (16.5%) and 15 (6.9%) had moved from the household. Out of these, 133 (79.6%) had never been operated (82 had indication for both eyes - 14 [17.1%] had bilateral surgery and 9 [11.0%] had unilateral surgery) and 34 had been previously operated in one eye and had indication for second eye (11 [32.4%] had surgery). Overall, only 55 (32.93%) participants had been operated for cataract, predominantly females (N=40) and individuals 60 years of age and older (N=51). Cataract surgery compliance was associated with age 60-69 years (P=0.021) and had no influence of either presenting or best corrected pre-operative VA, as well as gender, schooling and previous cataract surgery in one eye.
Despite providing expedited and free of charge surgery, a low compliance to cataract surgery was found in this population with many remaining visually impaired/blind because of cataract. Awareness campaigns and efforts to fight obstacles to cataract surgery adherence should be implemented by health authorities to increase cataract surgery uptake in older Brazilian adults.
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