山东省农村50岁及以上人群白内障患病率及手术状况的调查分析

Prevalence and surgery status of cataract in adults aged 50 years or above in rural Shandong Province

目的调查山东省农村50岁及以上人群白内障患病率、白内障手术覆盖率、白内障盲人社会负担率。设计以人群为基础的横断面调查。研究对象2008年4-7月在山东省不同经济发展水平的县(市)、区中选择4个县(市)、区(乳山市、滕州市、鄄城县、济南市槐荫区)作为调查地。抽取50岁及以上受检者17816例。方法对所有受检者进行视力和眼部检查,包括评价晶状体混浊程度和白内障手术状况。主要指标白内障患病率、人工晶状体(IOL)植入率、白内障手术覆盖率、白内障盲人社会负担率。结果在17816名受检者中,发现白内障4938例,患病率为27.72%。高龄、女性、文盲人群的白内障患病率较高,差异有统计学意义(P<0.01)。在受检的4938例白内障患者中,249例310眼接受了白内障手术,接受白内障手术的率为1.40%;其中194眼(62.58%)采用现代囊外摘除联合IOL植入术,32眼(10.32%)采用超声乳化吸除联合IOL植入术;239眼植入了IOL,IOL植入率为77.10%。白内障手术覆盖率为36.77%,白内障盲人社会负担率为2.12%。随着年龄增长和文化程度降低,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<0.05)。结论山东省农村50岁及以上人群的白内障患病率较高、白内障手术覆盖率仍较低,手术治疗白内障盲依然是防盲工作的重点。

Objective To assess the prevalence of cataract, the cataract surgical coverage rate, and the cataract-blindness social burden rate among older adults aged 50 years or above in rural populations in Shandong Province, China, in 2008. Design Popula- tion-based, cross-sectional study. Participants 17 816 individuals aged 50 years or above in three counties and one suburbs representa- tive of the different levels of socioeconomic development. Methods Visual acuity （VA）, lens and cataract operation status of all the in- dividuals were evaluated. Main Outcome Measures The prevalence of cataract, the rate of intraocular lens implantation, the cataract surgical coverage rate, and the cataract-blindness social burden rate. Results In 17 816 individuals, 4938 cases were suffered from cataract; the prevalence of cataract was 27.72%. The prevalence of cataract was higher in older people, female, and illiterate persons （P〈0.01）. In 310 eyes with cataract surgery, 62.58% and 10.32% of eyes were performed by the modern extra-capsular surgery and pho- coemusification respectively. The rate of intraocular lens implantation was 77.10%. The cataract surgical coverage rate was 36.77%, and the cataract-blindness social burden rate was 2.12%. The cataract-blindness social burden rate was higher in the aged persons and illit- erate persons （P〈0.01）. Conclusion The cataract surgical coverage rate is still lower in older adults aged 50 years or above in rural pop- ulations in Shandong Province. Surgery for cataract blindness is still the first important task in prevention of blindness in Shandong Province. （Ophthalmol CHN, 2013, 22： 234-239）