Outcomes of cataract surgery in Pakistan: results from The Pakistan National Blindness and Visual Impairment Survey
Aim: To evaluate the outcomes of cataract surgery in Pakistan. Methods: Cross-sectional, nationally representative sample of 16 507 adults (aged ⩾30 years). Each underwent interview, logarithm of the minimum angle of resolution visual acuity (VA), autorefraction, examination of optic disc. Those wit...
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| Veröffentlicht in: | British journal of ophthalmology 2007-04, Vol.91 (4), p.420-426 |
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| creator | Bourne, Rupert Dineen, Brendan Jadoon, Zahid Lee, Pak S Khan, Aman Johnson, Gordon J Foster, Allen Khan, Daud |
| description | Aim: To evaluate the outcomes of cataract surgery in Pakistan. Methods: Cross-sectional, nationally representative sample of 16 507 adults (aged ⩾30 years). Each underwent interview, logarithm of the minimum angle of resolution visual acuity (VA), autorefraction, examination of optic disc. Those with |
| doi_str_mv | 10.1136/bjo.2006.106724 |
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Methods: Cross-sectional, nationally representative sample of 16 507 adults (aged ⩾30 years). Each underwent interview, logarithm of the minimum angle of resolution visual acuity (VA), autorefraction, examination of optic disc. Those with <6/12 VA on presentation underwent best-corrected VA and dilated biomicroscopic ocular examination. Results: 1317 subjects (633 men) had undergone surgery in one or both eyes. Of the 1788 operated eyes, 1099 (61%) had undergone intracapsular cataract extraction (ICCE) and 607 (34%) extracapsular surgery with an intraocular lens (ECCE+IOL). Presenting VA: 275 (15.4%) eyes: 6/12 or better; 253 (14.1) <6/12 ⩾6/18; 632 (35.3%) 6/18 to 6/60; 85 (4.8%): 6/60 to 3/60; 528 (29.5%): <3/60. With “best” refractive correction, these values were: 563 (31.5%), 332 (18.6%), 492 (27.5%), 61 (3.4%), 334 (18.7%), respectively. Of the 1498 eyes with VA ⩽6/12 on presentation, 352 (23.5%) were the result of coincident disease, 800 (53.4%) refractive error and 320 (21.4%) operative complications. Eye camp surgery (OR 1.72, p = 0.002), ICCE (OR 3.78; p<0.001), rural residence (OR 1.36, p = 0.01), female gender (OR 1.55, p<0.001) and illiteracy (OR 2.44, p<0.001) were associated with VA of <6/18. More recent ICCE surgeries were associated with a poorer outcome. The ratio of ECCE+IOL:ICCE in the last 3 years was 1.2:1, compared with 1:3.3 ⩾4 years before the survey. Conclusion: Almost a third of cataract operations result in a presenting VA of <6/60, which could be halved by appropriate refractive correction. This study highlights the need for an improvement in quality of surgery with a more balanced distribution of services.]]></description><identifier>ISSN: 0007-1161</identifier><identifier>EISSN: 1468-2079</identifier><identifier>DOI: 10.1136/bjo.2006.106724</identifier><identifier>PMID: 17151060</identifier><identifier>CODEN: BJOPAL</identifier><language>eng</language><publisher>BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd</publisher><subject>Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cataract Extraction - methods ; Cataract Extraction - standards ; Cataract Extraction - utilization ; Cross-Sectional Studies ; Developing Countries ; ECCE+IOL ; extracapsular cataract extraction with intraocular lens ; Female ; Health Surveys ; Humans ; ICCE ; intracapsular cataract extraction ; intraocular lens ; IOL ; Lens diseases ; logarithm of the minimum angle of resolution ; logMAR ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Nd:YAG ; neodymium–yttrium–aluminium–garnet ; North West Frontier province ; NWFP ; Ophthalmology ; Pakistan ; Sex Distribution ; Treatment Outcome ; Vision disorders ; Vision Disorders - etiology ; Visual Acuity ; World View ; YAG ; yttrium–aluminium–garnet</subject><ispartof>British journal of ophthalmology, 2007-04, Vol.91 (4), p.420-426</ispartof><rights>Copyright 2007 British Journal of Ophthalmology</rights><rights>2007 INIST-CNRS</rights><rights>Copyright: 2007 Copyright 2007 British Journal of Ophthalmology</rights><rights>Copyright © 2007 BMJ Publishing Group</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b522t-892e8ce664d3219c9743a012be49b8052534861ff1ade44a164bbe5ee8dacda33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bjo.bmj.com/content/91/4/420.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://bjo.bmj.com/content/91/4/420.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,230,314,727,780,784,885,3194,23569,27922,27923,53789,53791,77370,77401</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18587975$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17151060$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bourne, Rupert</creatorcontrib><creatorcontrib>Dineen, Brendan</creatorcontrib><creatorcontrib>Jadoon, Zahid</creatorcontrib><creatorcontrib>Lee, Pak S</creatorcontrib><creatorcontrib>Khan, Aman</creatorcontrib><creatorcontrib>Johnson, Gordon J</creatorcontrib><creatorcontrib>Foster, Allen</creatorcontrib><creatorcontrib>Khan, Daud</creatorcontrib><title>Outcomes of cataract surgery in Pakistan: results from The Pakistan National Blindness and Visual Impairment Survey</title><title>British journal of ophthalmology</title><addtitle>Br J Ophthalmol</addtitle><description><![CDATA[Aim: To evaluate the outcomes of cataract surgery in Pakistan. Methods: Cross-sectional, nationally representative sample of 16 507 adults (aged ⩾30 years). Each underwent interview, logarithm of the minimum angle of resolution visual acuity (VA), autorefraction, examination of optic disc. Those with <6/12 VA on presentation underwent best-corrected VA and dilated biomicroscopic ocular examination. Results: 1317 subjects (633 men) had undergone surgery in one or both eyes. Of the 1788 operated eyes, 1099 (61%) had undergone intracapsular cataract extraction (ICCE) and 607 (34%) extracapsular surgery with an intraocular lens (ECCE+IOL). Presenting VA: 275 (15.4%) eyes: 6/12 or better; 253 (14.1) <6/12 ⩾6/18; 632 (35.3%) 6/18 to 6/60; 85 (4.8%): 6/60 to 3/60; 528 (29.5%): <3/60. With “best” refractive correction, these values were: 563 (31.5%), 332 (18.6%), 492 (27.5%), 61 (3.4%), 334 (18.7%), respectively. Of the 1498 eyes with VA ⩽6/12 on presentation, 352 (23.5%) were the result of coincident disease, 800 (53.4%) refractive error and 320 (21.4%) operative complications. Eye camp surgery (OR 1.72, p = 0.002), ICCE (OR 3.78; p<0.001), rural residence (OR 1.36, p = 0.01), female gender (OR 1.55, p<0.001) and illiteracy (OR 2.44, p<0.001) were associated with VA of <6/18. More recent ICCE surgeries were associated with a poorer outcome. The ratio of ECCE+IOL:ICCE in the last 3 years was 1.2:1, compared with 1:3.3 ⩾4 years before the survey. Conclusion: Almost a third of cataract operations result in a presenting VA of <6/60, which could be halved by appropriate refractive correction. This study highlights the need for an improvement in quality of surgery with a more balanced distribution of services.]]></description><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cataract Extraction - methods</subject><subject>Cataract Extraction - standards</subject><subject>Cataract Extraction - utilization</subject><subject>Cross-Sectional Studies</subject><subject>Developing Countries</subject><subject>ECCE+IOL</subject><subject>extracapsular cataract extraction with intraocular lens</subject><subject>Female</subject><subject>Health Surveys</subject><subject>Humans</subject><subject>ICCE</subject><subject>intracapsular cataract extraction</subject><subject>intraocular lens</subject><subject>IOL</subject><subject>Lens diseases</subject><subject>logarithm of the minimum angle of resolution</subject><subject>logMAR</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Nd:YAG</subject><subject>neodymium–yttrium–aluminium–garnet</subject><subject>North West Frontier province</subject><subject>NWFP</subject><subject>Ophthalmology</subject><subject>Pakistan</subject><subject>Sex Distribution</subject><subject>Treatment Outcome</subject><subject>Vision disorders</subject><subject>Vision Disorders - etiology</subject><subject>Visual Acuity</subject><subject>World View</subject><subject>YAG</subject><subject>yttrium–aluminium–garnet</subject><issn>0007-1161</issn><issn>1468-2079</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkc1v1DAQxSMEoqVw5oYsITggZWs7jh33gERXfFSUFomyHK2JM2m9TeLFTir2v8erXW2BCyfLfr95euOXZc8ZnTFWyON66WecUjljVCouHmSHTMgq51Tph9khpVTljEl2kD2JcZmuXDL1ODtgipVpgh5m8XIare8xEt8SCyMEsCOJU7jGsCZuIF_h1sURhhMSME7dGEkbfE-ubnAvkQsYnR-gI6edG5oBYyQwNGTh4pQez_oVuNDjMJJvU7jD9dPsUQtdxGe78yj7_uH91fxTfn758Wz-7jyvS87HvNIcK4tSiqbgTFutRAGU8RqFrita8rIQlWRty6BBIYBJUddYIlYN2AaK4ih7u_VdTXWPjU0JAnRmFVwPYW08OPO3Mrgbc-3vDNNaKKGSweudQfA_J4yj6V202HUwoJ-iUZRrWUidwJf_gEs_hfQj0TCl0iKiECxRx1vKBh9jwHYfhVGzqdOkOs2mTrOtM028-HODe37XXwJe7QCIFro2wGBdvOeqslJalYnLt1wqDH_tdQi3RqpCleZiMTc_Pn8p9OmCms3mb7Z83S__m_I3T13GVg</recordid><startdate>20070401</startdate><enddate>20070401</enddate><creator>Bourne, Rupert</creator><creator>Dineen, Brendan</creator><creator>Jadoon, Zahid</creator><creator>Lee, Pak S</creator><creator>Khan, Aman</creator><creator>Johnson, Gordon J</creator><creator>Foster, Allen</creator><creator>Khan, Daud</creator><general>BMJ Publishing Group Ltd</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20070401</creationdate><title>Outcomes of cataract surgery in Pakistan: results from The Pakistan National Blindness and Visual Impairment Survey</title><author>Bourne, Rupert ; Dineen, Brendan ; Jadoon, Zahid ; Lee, Pak S ; Khan, Aman ; Johnson, Gordon J ; Foster, Allen ; Khan, Daud</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b522t-892e8ce664d3219c9743a012be49b8052534861ff1ade44a164bbe5ee8dacda33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cataract Extraction - methods</topic><topic>Cataract Extraction - standards</topic><topic>Cataract Extraction - utilization</topic><topic>Cross-Sectional Studies</topic><topic>Developing Countries</topic><topic>ECCE+IOL</topic><topic>extracapsular cataract extraction with intraocular lens</topic><topic>Female</topic><topic>Health Surveys</topic><topic>Humans</topic><topic>ICCE</topic><topic>intracapsular cataract extraction</topic><topic>intraocular lens</topic><topic>IOL</topic><topic>Lens diseases</topic><topic>logarithm of the minimum angle of resolution</topic><topic>logMAR</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Nd:YAG</topic><topic>neodymium–yttrium–aluminium–garnet</topic><topic>North West Frontier province</topic><topic>NWFP</topic><topic>Ophthalmology</topic><topic>Pakistan</topic><topic>Sex Distribution</topic><topic>Treatment Outcome</topic><topic>Vision disorders</topic><topic>Vision Disorders - etiology</topic><topic>Visual Acuity</topic><topic>World View</topic><topic>YAG</topic><topic>yttrium–aluminium–garnet</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bourne, Rupert</creatorcontrib><creatorcontrib>Dineen, Brendan</creatorcontrib><creatorcontrib>Jadoon, Zahid</creatorcontrib><creatorcontrib>Lee, Pak S</creatorcontrib><creatorcontrib>Khan, Aman</creatorcontrib><creatorcontrib>Johnson, Gordon J</creatorcontrib><creatorcontrib>Foster, Allen</creatorcontrib><creatorcontrib>Khan, Daud</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bourne, Rupert</au><au>Dineen, Brendan</au><au>Jadoon, Zahid</au><au>Lee, Pak S</au><au>Khan, Aman</au><au>Johnson, Gordon J</au><au>Foster, Allen</au><au>Khan, Daud</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of cataract surgery in Pakistan: results from The Pakistan National Blindness and Visual Impairment Survey</atitle><jtitle>British journal of ophthalmology</jtitle><addtitle>Br J Ophthalmol</addtitle><date>2007-04-01</date><risdate>2007</risdate><volume>91</volume><issue>4</issue><spage>420</spage><epage>426</epage><pages>420-426</pages><issn>0007-1161</issn><eissn>1468-2079</eissn><coden>BJOPAL</coden><abstract><![CDATA[Aim: To evaluate the outcomes of cataract surgery in Pakistan. Methods: Cross-sectional, nationally representative sample of 16 507 adults (aged ⩾30 years). Each underwent interview, logarithm of the minimum angle of resolution visual acuity (VA), autorefraction, examination of optic disc. Those with <6/12 VA on presentation underwent best-corrected VA and dilated biomicroscopic ocular examination. Results: 1317 subjects (633 men) had undergone surgery in one or both eyes. Of the 1788 operated eyes, 1099 (61%) had undergone intracapsular cataract extraction (ICCE) and 607 (34%) extracapsular surgery with an intraocular lens (ECCE+IOL). Presenting VA: 275 (15.4%) eyes: 6/12 or better; 253 (14.1) <6/12 ⩾6/18; 632 (35.3%) 6/18 to 6/60; 85 (4.8%): 6/60 to 3/60; 528 (29.5%): <3/60. With “best” refractive correction, these values were: 563 (31.5%), 332 (18.6%), 492 (27.5%), 61 (3.4%), 334 (18.7%), respectively. Of the 1498 eyes with VA ⩽6/12 on presentation, 352 (23.5%) were the result of coincident disease, 800 (53.4%) refractive error and 320 (21.4%) operative complications. Eye camp surgery (OR 1.72, p = 0.002), ICCE (OR 3.78; p<0.001), rural residence (OR 1.36, p = 0.01), female gender (OR 1.55, p<0.001) and illiteracy (OR 2.44, p<0.001) were associated with VA of <6/18. More recent ICCE surgeries were associated with a poorer outcome. The ratio of ECCE+IOL:ICCE in the last 3 years was 1.2:1, compared with 1:3.3 ⩾4 years before the survey. Conclusion: Almost a third of cataract operations result in a presenting VA of <6/60, which could be halved by appropriate refractive correction. This study highlights the need for an improvement in quality of surgery with a more balanced distribution of services.]]></abstract><cop>BMA House, Tavistock Square, London, WC1H 9JR</cop><pub>BMJ Publishing Group Ltd</pub><pmid>17151060</pmid><doi>10.1136/bjo.2006.106724</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Distribution Aged Aged, 80 and over Biological and medical sciences Cataract Extraction - methods Cataract Extraction - standards Cataract Extraction - utilization Cross-Sectional Studies Developing Countries ECCE+IOL extracapsular cataract extraction with intraocular lens Female Health Surveys Humans ICCE intracapsular cataract extraction intraocular lens IOL Lens diseases logarithm of the minimum angle of resolution logMAR Male Medical sciences Middle Aged Miscellaneous Nd:YAG neodymium–yttrium–aluminium–garnet North West Frontier province NWFP Ophthalmology Pakistan Sex Distribution Treatment Outcome Vision disorders Vision Disorders - etiology Visual Acuity World View YAG yttrium–aluminium–garnet |
| title | Outcomes of cataract surgery in Pakistan: results from The Pakistan National Blindness and Visual Impairment Survey |
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