Prevalence and Visual Outcomes of Cataract Surgery in Rural South India: A Cross-Sectional Study

ABSTRACT

Purpose: To determine the prevalence of cataract surgery and postoperative vision-related outcomes, especially with respect to sex, socioeconomic status (SES) and site of first contact with eye care, in a rural area of South India.

Methods: In a population-based cross-sectional survey of 5530 individuals aged 50 years or older from 10 villages selected by cluster sampling, individuals who had undergone cataract surgery in one or both eyes were identified. Consenting participants were administered a questionnaire, underwent vision assessment and ophthalmic examination. Outcomes were classified as good if visual acuity of the operated eye was 6/18 or better, fair if worse than 6/18 but better than or equal to 6/60, and poor if worse than 6/60.

Results: Prevalence of cataract surgery in this age group (771 persons) was 13.9% (95% confidence interval, CI, 13.0–14.9%). In the 1112 eyes of 749 persons studied, at presentation, 53.1% (95% CI 50.1–56.1%) of operated eyes had good, 38.1% (95% CI 35.2–41.0%) had fair, and 8.8% (95% CI 7.1–10.5%) had poor outcomes. With pinhole, 75.2% (95% CI 72.6–77.8%) had good, 17.2% (95% CI 14.9–19.5%) had fair, and 7.4% (95% CI 5.8–9.0%) had poor outcomes. In 76.3% of eyes with fair and poor presenting outcomes we detected an avoidable cause for the suboptimal visual acuity. Place of surgery and duration since surgery of 3 years or more were risk factors for blindness, while SES, sex and site of first eye care contact were not.

Conclusion: The high prevalence of avoidable causes of visual impairment in this rural setting indicates the scope for preventive strategies.

KEYWORDS:

• Avoidable blindness
• cataract surgery
• eye camp
• prevalence
• visual outcomes

Acknowledgments

The health aides of the hospital, the social workers involved in the study and the patients who had had cataract surgery deserve special thanks for their cooperation.

Funding

Our study was funded partially by the Ministry of Health and Family Welfare, Government of India as part of funds allocated for surveys to the Sentinel Surveillance Units, of which Vellore is one, and partially by an institutional fluid research grant.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article.

Additional information

Funding

Our study was funded partially by the Ministry of Health and Family Welfare, Government of India as part of funds allocated for surveys to the Sentinel Surveillance Units, of which Vellore is one, and partially by an institutional fluid research grant.