北京市城乡限定人群白内障手术负荷量及术后视力评价

A prevalence survey of cataract surgical burden and evaluation of the postoperative vision in rural and urban defined populations in Beijing

目的 :探讨北京限定区域城市及农村人群白内障患病率、低视力及手术负荷量 ,分析白内障手术覆盖率及术后视力情况。方法 :晶状体图像资料完整的 4 0岁以上受试者 4 36 4人 (农村 190 9人 ,城市 2 4 5 5人 ) ,所有受试者均进行问卷调查及眼部检查。眼部检查包括裸眼及矫正视力、电脑验光、眼压、散瞳后裂隙灯检查 ,数码照相采集晶状体图象及眼底照相。白内障手术负荷量入选标准 :(1)符合白内障诊断 ;(2 )除外角膜病、青光眼、眼底病、严重沙眼性角膜混浊等影响视力的疾病 ;(3)标准一 :单眼矫正视力≤ 0 3;标准二 :双眼矫正视力≤ 0 3。结果 :本次调查白内障患病率为 16 3% ,其中双眼矫正视力≤ 0 3者14例 ,手术负荷量为 0 32 % (农村 0 5 2 % ,城市 0 16 % ) ;单眼矫正视力≤ 0 3者 6 7例 ,手术负荷量为 1 5 4 % (农村 1 89% ,城市 1 2 6 % )。对白内障手术需求女性大于男性 ,随年龄增加 ,需求上升 ,农村高龄女性需求最大。已行白内障手术者共 5 5例(72只眼 ) ,总的白内障手术覆盖率为 7 0 3% ,其中农村为 4 71% ,城市为 9 0 3% ,女性 6 6 9% ,男性为 7 33% ,农村女性的手术覆盖率最低 ,为 3 77%。白内障手术后矫正视力≤ 0 3者占 18 0 6 %。术后视力不佳的原因为后发性白内障、眼底病变及其?

Objective:To assess the prevalence of cataract,low vision and cataract surgical burden,and to estimate the cataract surgical coverage and postoperative vision in rural and urban defined populations in Beijing.Methods:A total of 4364 subjects(1909 of rural subjects and 2455 of urban subjects) aged 40 years or more in rural and urban defined populations in Beijing included this survey.All participants came from four communities in the north of Beijing and three communities of Yufa in south country of Beijing,China.Each subject was examined including questionnaire and ocular examination.The detailed questionnaire included medical history of systemic and eye disorders,family history,etc.Ophthalmologic examination included visual acuity determination and refraction,intraocular pressure measurement,slit-lamp biomicroscopy examination for lens and fundus evaluation after pupil dilated.The application of digital photography technology(lens cortex and posterior subcapsular photography can be collected with Neitz CT-R cataract illumination analyzer.)had accelerated greatly on the evaluation of lens and fundus.The criteria for cataract surgical burden were:(1) being diagnosed as cataract;(2)having excluded other eye disorders which influenced visual acuity such as corneal diseases,glaucoma,fundus diseases,corneal scarring due to trachoma;(3)corrected visual acuity in one eye was equal to or less than 0.3;or visual acuity in both eyes were equal to or less than 0.3.Results:The prevalence of cataract was 16.30%.Visual acuity of 0.3 or worse in both eyes was obtained in 14 individuals among cataract patients.The overall rate of the cataract surgical burden was 0.32%,0.52% in rural population and 0.16% in urban population.Visual acuity of 0.3 or worse in at least one eye was obtained in 67 individuals among cataract patients.The overall rate of the cataract surgical burden was 1.54%,1.89% in rural population and 1.26% in urban population.Cataract surgical need in female was more than that in male and this tendency was increasing with age,the surgical need in rural elderly female was most desperate.A total of 55 individuals(72 eyes) had cataract surgical history,the overall cataract surgical coverage was 7.03%,4.71% in rural and 9.03% in urban populations,6.69% in female and 7.33% in male.The lowest cataract surgical coverage was 3.77% in rural female.At survey,18.06% of the postoperative patients were identified visual acuity of 0.3 or worse.The reasons for poor postoperative vision were after-cataract,fundus diseases such as optic nerve atrophy,diabetes retinopathy,and surgical complication such as bullous keratopathy,etc.Conclusion:The need for cataract surgery in rural population is more than that in urban population.Rural elderly females are in desperate need for cataract surgery.The postoperative vision is not as good as expected.The need for cataract surgery in the defined populations of Beijing exceeds the currently available capacity of cataract surgery.