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N. G. Congdon, D. S. C. Lam, S. K. Rao, Y. P. Liu, L. S. Zhang, S. F. Lin, A. H. Fan, K. Choi; Visual Outcomes, Impact of Post-Operative Interventions and Uptake of Additional Services in a Cataract Surgical Program in Rural China. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5440.
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Poor results have been reported for cataract surgery in rural China, with low uptake of services. We sought to assess the outcomes of cataract surgery, the impact of post-operative interventions and potential for uptake of post-operative services in a rural Chinese setting.
Patients undergoing surgery during the first three months of independent operation by two recently-trained local Chinese surgeons using the sutureless, large-incision, manual cataract extraction (SLIMCE) technique at a village hospital were invited for examination and quality of life/visual function interviews. YAG capsulotomy, cataract surgery in the fellow eye and spectacle prescriptions were offered where clinically indicated.
239/313 (76%) of eligible subjects could be contacted; 176 (74%) of these were examined, 60 (26%) underwent telephone interviews, and 3 refused exam or interview. Examined and interviewed patients did not differ significantly from those who could not be contacted with regards to age, gender, pre-op or Day 1 post-op vision. Among examined patients, 38 (22%) had undergone bilateral surgery, 86% had pre-op presenting VA <= 6/60 in the operative eye, and presenting and best-corrected post op vision were >= 6/18 in 85% and 96% respectively. 16 patients (9%) were recommended capsulotomy and 15 (94%) complied. 25/66 (38%) of patients who improved by >= 2 lines with refraction in either eye accepted spectacle prescriptions. 19/26 (73%) of patients with presenting post-op VA < 6/18 in the operative eye could improve to >= 6/18 with post-op interventions, and 15/26 (58%) accepted interventions. 17/65 (26%) of patients with visually significant cataract in the fellow eye accepted surgery. Reasons for intervention refusal, quality of life, visual function, near vision and ocular co-morbidities will be discussed.
This is one of the first detailed studies of cataract surgery and the impact of post-operative interventions in rural China. Excellent results are possible in this setting, though better uptake of post-operative services would improve these results still further.
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