Impact of posterior subcapsular opacification on vision and visual function among subjects undergoing cataract surgery in rural China: Study of Cataract Outcomes and Up-Take of Services (SCOUTS) in the Caring is Hip Project, Report 5

Abstract

The prevalence of PCO and impact on vision and visual function in this cohort was modest 1 year after surgery. However, PCO prevalence increases with time. Follow-up of this cohort is underway to determine the effectiveness of this early intervention in identifying and treating subjects who will eventually experience clinically significant PCO.

Sources of patient knowledge and financing of cataract surgery in rural China: the Sanrao Study of Cataract Outcomes and Up-Take of Services (SCOUTS), Report 6

“…Interestingly, however, having paid for one’s own surgery was the single most important determinant of being willing to undergo second-eye surgery in this cohort, an association that persisted after adjustment for other potential predictors such as age, visual result in the first eye, and urban versus rural residence (table 3). Second-eye surgery has been shown to significantly improve self-reported visual function in this setting,29 and can be an important source of income in self-sustaining programmes such as this one.…”

Sustainability of visual acuity in the first 2 years after cataract surgery

“…In addition, our study had a moderate drop-out rate. Previous studies of cataract surgical outcomes with large numbers of patients (N >200) and long-term follow-up periods (≥4 months) have reported a range of follow-up rates between 73% and 75% 17 22 23. Our 72% follow-up rate over the 2-year period is therefore reasonable.…”

Cost and Expected Visual Effect of Interventions to Improve Follow-up After Cataract Surgery

“…Thus, we cannot infer that all or even most of these patients had impaired VA without glasses. A previous study 18 reported that only 35% of patients with a similar 2-line improvement in VA in rural China would accept prescriptions, mostly owing to a lack of perceived need. Nonetheless, because only 5 of 40 hospitals in PRECOG (12.5%) reached the World Health Organization standard (80% of patients with uncorrected VA of 6/18 or better), 14 investments in better biometric measurements and more complete stocks of intraocular lenses could improve this rate.…”

“…For strategies 2, 3, and 4, an estimated 11% of those who did not return for follow-up would purchase glasses. These figures are based on studies of spectacle purchase among patients with cataract in China 18 and Iran. 19 For those with a complication requiring surgery, the mean price of surgery was added plus the cost of 2 extra visits and the consensus price of postoperative medication.…”

“…The high global 18 and Hashemi et al 19 mean cost per patient improved from interventions such as telephone calls and transportation support may be compared with the ICER $52.05 (spontaneous + telephone interventions) in Asia (in the best case where all patients accepted postoperative care) because of the low cost of glasses and transportation there. Reduction in the cost of glasses and treatment of complications due to government, insurance, or other external subsidies or by other means, such as the use of ready-made spectacles, 28 would likely improve acceptance and thus the effect on VA and costeffectiveness.…”