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Outcomes and Projected Impact of the China Million Cataract Surgeries Program           ★★★
Outcomes and Projected Impact of the China Million Cataract Surgeries Program
作者:严茜茜 文章来源:中山大学中山眼科中心 点击数:302 更新时间:2012/9/13

Purpose The recently-completed Chinese “Million Cataract Surgeries Program” (MCSP) is among the largest such campaigns ever, providing one million surgeries. We report MCSP outcomes for the first time, inJiangxi, a province with one-eighth of total program output.

Methods Ten county hospitals participating in MCSP were selected from rich and poor areas of Jiangxi (gross domestic product [GDP] per capita 2998 - 743 USD). An Australian-based NGO had trained surgeons at these hospitals and at 64 (79.0%) of 81 county facilities in Jiangxi. Each center sought to enroll seventy-five consecutive MCSP patients aged 50 years. Data recorded included: type of cataract procedure, bilateral un-corrected and best-corrected visual acuity (UCVA, BCVA) and refractive error pre and ≥ 50 days post-operatively.

Results Among 715 subjects (mean age 72.3±9.1 years, 55.5% female), pre-operative UCVA was < 3/60 bilaterally in 13.3% and unilaterally in 50.9%.  Small incision cataract surgery was performed in 92.3%. Among 662 (92.6%) patients completing follow-up, BCVA was ≥ 6/18 in 80.1%, UCVA was > 6/18 in 57.1% and BCVA was < 3/60 in 2.1%. Among persons with UCVA < 6/18, 152(53.5%) achieved BCVA > 6/18 with refraction. The proportion of patients with good UCVA postoperative who had surgery at high -volume hospitals was larger than low-volume ones (P < 0.05). Older age (P < 0.001), female sex (P=0.04), worse refractive error (P =0.02), presence of intra- (P=0.002) and post-operative surgical complications (P < 0.001), were independently associated with UCVA post-operative. Based on these results, the MCSP cured an estimated 96,600 cases of bilateral and 442,050 of unilateral blindness.

Conclusions Due to relatively good outcomes and a large number of surgeries, the sight-restoring impact of the MCSP was likely substantial. 





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