我国九省眼病调查中江苏省启东市50岁及以上人群白内障患病率和手术状况的调查

Prevalence and surgery status of cataract among adults aged 50 years or above in Qidong City of Jiangsu Province： the China Nine-Province Survey

目的调查2006年江苏省启东市50岁及以上人群中白内障患病率、白内障手术覆盖率和白内障盲人社会负担率。方法采用整群随机抽样研究方法。2006年9—12月在江苏省启东市抽取16个调查点，共对5141例50岁及以上成人进行视力和眼部检查，包括裂隙灯显微镜检查评价晶状体混浊程度和白内障手术情况。应用多元逻辑回归分析受检者不同年龄、性别和受教育程度对白内障患病率、白内障手术覆盖率、白内障盲人社会负担率及白内障术后视力效果的影响。结果5141例受检者中，发现白内障1098例，患病率为21．35％。高龄、女性和受教育程度低的人群白内障患病率明显增高，差异均有统计学意义（P〈0．01）。在施行白内障手术的89只眼中，采用现代囊外摘除联合人工晶状体（IOL）植入术23只眼（25．84％），白内障超声乳化吸除术联合IOL植入术38只眼（42．70％），IOL植入率为69．66％。术后日常生活视力和最佳矫正视力90．7的眼分别占总数的24．72％和48．31％，术后视力差的主要原因是视网膜疾病、晶状体后囊膜混浊和青光眼。白内障手术覆盖率为37．96％，白内障盲人社会负担率为2．10％。随着年龄的增长和受教育程度的降低，白内障手术覆盖率逐渐降低，白内障盲人社会负担率逐渐增高，这种变化趋势有统计学意义（P〈0．01）。结论江苏省启东市高龄人群中自内障手术覆盖率仍较低，防盲工作的首要任务仍是根治白内障盲。白内障手术的视力预后有待于进一步提高。

Objective To estimate the prevalence of cataract, the rate of cataract surgical coverage rate, and the rate of cataract-blindness social burden among older adults aged 50 years or above in Qidong City of Jiangsu Province, China, in 2006. Methods Cluster sampling was used in randomly selected 5662 individuals aged 50 years or above in 16 clusters in Qidong City. 5141 individuals received visual acuity and eye examination from September to December 2006. Lens and cataract operation status were evaluated by slit lamp. Multiple logistic regression analysis was employed to analyed the prevalence of cataract, cataract surgical coverage rate, cataract blindness social burden rate and outcomes of surgery among different ages, sex and educational background. Results In 5141 individuals, 1098 cases of cataract were found, the prevalence of cataract was 21.35% among adults aged 50 or above. The prevalence of cataract was higher in the aged, female, illiterate persons （ P 〈 0. 01 ）. In 89 eyes with cataract surgery, 25.84% and 42. 70% of eyes were performed by the modem extra-capsular surgery and phocoemusification respectively. The rate of intraocular lens implantation was 69. 66%. Post-operative presenting and best corrected visual acuity more than 0. 7 was 24. 70% and 48.31% of operated eyes respectively. The main causes of the post-operated eyes with worse visual acuity were retinal disorders post-capsular opacity and glaucoma. The cataract surgical coverage rate was 37.96% ,and the cataract blindness social burden rate was 2. 10%. The cataract blindness social burden rate was higher in the aged persons （P 〈 0. 01 ）. Conclusions Cataract is the most common and important eye disease that may lead into blindness and severe visual impairment among older adults aged 50 years or above. The cataract surgical coverage rate is not so high in Qidong City, and even lower in the aged persons. The first important task in blindness prevention still is the elimination of cataract blindness. The visual outcomes of the cataract surgery should be further improved in the future.