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目的调查陕西省农村≥50岁老年人群中白内障盲的患病率和白内障手术覆盖率及其术后效果。方法2003年7～12月,采用整体随机分层抽样法在陕西省洋县、靖边县和富平县调查8500人,其中≥50岁人群2213人,所有受检人员均进行标准问卷调查及详细的眼科检查。视力检查使用LogMAR视力表分别对每只眼进行测量,晶状体混浊使用LOCSIII进行评价。结果≥50岁人群双眼盲和双眼低视力的患病率为2.1%,3.2%,其中女性患病率均高于男性(P<0.05)。由白内障造成的视力损伤患病率为6.9%,其中50岁人群中白内障造成的视力损伤患病率为2.4%,70岁人群则上升到17.9%,随着年龄的增加,患病率明显上升(P<0.01)。该人群中双眼视力<0.1的白内障手术负荷量为2.3%,手术覆盖率为37.0%,白内障盲的社会负担率为3.1%。在25只白内障手术眼中,实施ICCE手术眼10只,ECCE手术眼15只,无PHACO手术眼。其中ICCE术后矫正视力>0.3的占40.0%,ECCE术后矫正视力>0.3占53.3%。结论陕西省农村老年人群中由白内障造成的视力损伤还是一个比较严重的问题。该人群中白内障手术覆盖率还比较低,白内障术后效果没有达到病人的预期目标。
Objective To investigate the prevalence of cataract blindness and the coverage of cataract surgery and its postoperative effects in the elderly population aged ≥50 years in rural areas of Shaanxi Province. Methods From July to December 2003, 8500 people were surveyed in Yangxian County, Jingbian County and Fuping County by using the randomized stratified random sampling method. Among them, 2213 were ≥50 years old, and all the interviewees conducted standard questionnaire survey and detailed Eye examination. Eye exams were performed on each eye separately using a LogMAR eye chart and lens opacity was evaluated using LOCS III. Results The prevalence of binocular blindness and binocular low vision was 2.1% and 3.2% in ≥50 years old group, and the prevalence of female was higher than that of male (P <0.05). The prevalence of visual impairment due to cataracts was 6.9%. The prevalence of visual impairment due to cataracts was 2.4% in 50-year-olds and 17.9% in 70-year-olds. The prevalence rose markedly with age (P <0.01). In this population, binocular surgery load was 2.3% for binocular visual acuity <0.1, surgical coverage was 37.0%, and social burden for cataract blindness was 3.1%. In 25 cataract surgery eyes, 10 ICCE eyes, 15 ECCE eyes and no PHACO eyes were performed. ICCE postoperative corrected visual acuity> 0.3 accounted for 40.0%, ECCE corrected visual acuity> 0.3 accounted for 53.3%. Conclusion The visual impairment caused by cataract in rural elderly population in Shaanxi Province is still a serious problem. The population coverage of cataract surgery is still relatively low, the effect of cataract surgery did not meet the patient’s desired goal.