WORLD VIEW

Cataract surgical coverage and outcome in the Tibet Autonomous Region of China

K L Bassett^1,4, K Noertjojo¹, L Liu^1,3, F S Wang², C Tenzing⁴, A Wilkie⁴, M Santangelo⁴ and P Courtright¹

¹ British Columbia Centre for Epidemiologic and International Ophthalmology, Vancouver BC V6T 1Z3, Canada
² Tibet Autonomous Region Public Health Bureau, Tibet
³ Kilimanjaro Centre for Community Ophthalmology, Tanzania
⁴ Seva Foundation, Seva Canada, Canada

Correspondence to:
Correspondence to:
Dr Ken Bassett
Director, British Columbia Centre for Epidemiologic and International Ophthalmology, Department of Ophthalmology, The University of British Columbia, 429-2194 Health Sciences Mall, Vancouver BC V6T 1Z3, Canada; bassett{at}chspr.ubc.ca

Background: A recently published, population based survey of the Tibet Autonomous Region (TAR) of China reported on low vision, blindness, and blinding conditions. This paper presents detailed findings from that survey regarding cataract, including prevalence, cataract surgical coverage, surgical outcome, and barriers to use of services.

Methods: The Tibet Eye Care Assessment (TECA) was a prevalence survey of people from randomly selected households from three of the seven provinces of the TAR (Lhoka, Nakchu, and Lingzhr), representing its three main environmental regions. The survey, conducted in 1999 and 2000, assessed visual acuity, cause of vision loss, and eye care services.

Results: Among the 15 900 people enumerated, 12 644 were examined (79.6%). Cataract prevalence was 5.2% and 13.8%, for the total population, and those over age 50, respectively. Cataract surgical coverage (vision <6/60) for people age 50 and older (85–90% of cataract blind) was 56% overall, 70% for men and 47% for women. The most common barriers to use of cataract surgical services were distance and cost. In the 216 eyes with cataract surgery, 60% were aphakic and 40% were pseudophakic. Pseudophakic surgery left 19% of eyes blind (<6/60) and an additional 20% of eyes with poor vision (6/24–6/60). Aphakic surgery left 24% of eyes blind and an additional 21% of eyes with poor vision. Even though more women remained blind than men, 28% versus 18% respectively, the different was not statistically significant (p = 0.25).

Conclusions: Cataract surgical coverage was remarkably high despite the difficulty of providing services to such an isolated and sparse population. Cataract surgical outcome was poor for both aphakic and pseudophakic surgery. Two main priorities are improving cataract surgical quality and cataract surgical coverage, particularly for women.

Abbreviations: TAR, Tibet Autonomous Region; TECA, Tibet Eye Care Assessment

Keywords: cataract; Tibet

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Lewallen, S, Mousa, A, Bassett, K, Courtright, P (2009). Cataract surgical coverage remains lower in women. Br. J. Ophthalmol. 93: 295-298 [Abstract] [Full Text]  
• Jadoon, Z, Shah, S P, Bourne, R, Dineen, B, Khan, M A, Gilbert, C E, Foster, A, Khan, M D, on behalf of the Pakistan National Eye Survey Stud, (2007). Cataract prevalence, cataract surgical coverage and barriers to uptake of cataract surgical services in Pakistan: the Pakistan National Blindness and Visual Impairment Survey. Br. J. Ophthalmol. 91: 1269-1273 [Abstract] [Full Text]