Relationship between diabetes mellitus and cataract in Hungary

AIM:To examine the coexistence of diabetes mellitus(DM)and cataract in Hungary.The effects of DM on the cataract surgical results were also in the focus of analysis.METHODS:Statistical data analysis of the results of the Rapid Assessment of Avoidable Blindness with Diabetic Retinopathy(RAAB+DR)module conducted in Hungary in 2015.This cross-sectional,population-based,national survey included 3523 people aged 50 years and over.Participants of the survey were examined on-site.Visual acuity,main cause for visual impairment(using direct and indirect ophthalmoscopes),in case of best corrected visual acuity(BCVA)≤0.5 and blood glucose level(random test with glucometer)were examined.RESULTS:The prevalence of cataract was 23.4%,and DM was 20.0%.The occurrence of cataract steadily increased with age.Among the examined participants with DM,the prevalence of cataract was significantly(P=0.012)higher(+35%)than that in non-diabetic subjects(29.5%vs 21.8%).Following aging(OR=15.2%,P<0.001),DM proved to be the most independent influencing risk factor(OR=49.9%,P<0.001).The presence of DM was neither an influencing factor for complications of cataract surgery,nor for postoperative visual acuity.CONCLUSION:DM appears to be one of the main risk factors for developing cataract.Other risk factors,such as age,sex and environment also play an influencing role.Diabetes does not seem to affect the occurrence of cataract surgical complications.

Cataract blindness in Hungary

AIM:To estimate the prevalence of blindness and visual impairment resulting from cataract in the population aged≥50 y in Hungary,and to assess the cataract surgical services.METHODS:A rapid assessment of avoidable blindness(RAAB)was conducted.A total of 3523 eligible people were randomly selected and examined.Each participant underwent surgery for cataract was interviewed with regard to the year,place,and costs of the surgery.Participants with obvious cataract were asked why they had not yet undergone surgery(barriers to surgery).RESULTS:An estimated 12514 people were bilaterally blind;the visual acuity(VA)in 19293 people was<6/60,and the VA in 73962 people was<6/18 in the better eye due to cataract.An estimated 77933 eyes are blind;98067 eyes had a VA of<6/60,and an estimated 277493 eyes had a VA of<6/18 due to cataract.Almost all cataract surgeries were conducted in government hospitals.The age-and sexadjusted cataract surgical coverage with VA<3/60 in eyes was 90.0%.The rate of good visual outcome after surgery was 79.5%.Ocular comorbidity was the main cause of poor outcome(78.1%),followed by late complications(such as posterior capsule opacification)(17.2%),inadequate optical correction(3.1%),and surgical complications(1.6%).The main barrier to surgery in people with bilateral cataract and VA of<6/60 was‘need not felt’.CONCLUSION:The prevalence of visual impairment resulting from cataract is slightly higher than expected.The quality of the cataract surgical service seems adequate in Hungary.However,the number of cataract operations per year should continue to increase due to the increasing patient demands and the aging population.