To measure visual acuity and vision-related quality of life in individuals in rural
China operated on for cataract.
Five thousand fifty-two persons age 50 years and older, 90.9% (5,052/5,555) of a randomly
selected population in Shunyi County, were examined in the fall of 1996. Visual functioning
and quality of life questionnaires were administered to those with presenting visual
acuity less than 6/60 in either eye and to those who were aphakic or pseudophakic.
Of the 87 individuals operated on for cataract, 12% (10/87) had presenting visual
acuity of 6/18 or more in both eyes, and 24.1% (21/87) had less than 6/60. Twenty-five
percent (29/116) of the 116 eyes operated on for cataract had presenting visual acuity
of 6/18 or more, and 44.8% (52/116) had less than 6/60. Aphakic cases without glasses
and uncorrectable aphakia attributable to surgical complications were common. In a
multivariate regression model, including time period of surgery, hospital type, and
surgical procedure, only pseudophakia was associated with better outcomes (P = .05).
On a scale from 0 (maximum problems) to 100 (no problems), the mean visual functioning
score (+/-SD) for the operated-on population was 61.9 +/- 30.0, and 71.0 +/- 31.8
for the quality of life questionnaire. These scores were comparable to those of the
unoperated-on population with moderate bilateral blindness (<6/60 to > or =3/60 in
the better eye). Visual functioning and quality of life scores were closely correlated
with visual acuity in operated-on (r = 0.64 and r = 0.61, respectively) and unoperated-on
populations (r = 0.68 and r = 0.59, respectively).
Both clinical and patient-reported cataract surgery outcomes are below what should
be achievable. Improvement in outcomes must be given greater emphasis if the potential
of cataract surgery in restoring sight is to be realized.