Outcomes of Cataract Surgery in Urban and Rural Population in the South Indian State of Andhra Pradesh: Rapid Assessment of Visual Impairment (RAVI) Project

Marmamula, Srinivas; Khanna, Rohit C; Shekhar, Konegari; Rao, Gullapalli N

doi:10.1371/journal.pone.0167708

Cited by 22 publications

(22 citation statements)

References 28 publications

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“…Visual outcomes after cataract surgery were better than in many other LMIC (Table 5) [19][20][21][22][23][24][25][34][35][36][37][38][39], with poor outcomes only slightly higher than the WHO recommended levels of <5% (12.1% presenting VA; 8.8% best correction VA). Visual outcomes have improved significantly in Sri Lanka due to the near universal use of IOLs, which have recently been provided free by the Ministry of Health.…”

Section: Discussionmentioning

confidence: 87%

Prevalence and visual outcomes of cataract surgery and cataract surgical coverage in Sri Lanka: findings from the National Blindness and Visual Impairment Survey

et al. 2018

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Introduction Cataract surgical coverage and visual acuity outcomes are important population level indicators for monitoring access to and the quality of cataract surgery, allowing subgroups with poorer access to be identified. Data on these indicators are not available for Sri Lanka at national level. Objectives Determine cataract surgical coverage and the outcomes of cataract surgery in a nationally representative sample of adults aged 40 years. Methods Cluster random sampling with proportionate to size procedures was used. All participants were interviewed to obtain data on education level, movable assets, and the year and place of cataract surgery, if applicable. Presenting and best corrected visual acuities were measured. All participants underwent slit lamp examination, including a dilated examination of the fundus. Cataract surgical coverage was calculated at the person level vision of <3/30, <6/60 and <6/18. Outcomes of cataract surgery were categorized as good (6/18 or better), borderline (<6/18-6/60) or poor (<6/60). Results A total of 345 persons among the 5,779 participants who were examined had undergone cataract surgery in one or both eyes (486 eyes). Cataract surgical coverage, which was high overall 85.4% for vision <3/60; 79.1% for vision <6/60), was significantly higher in younger age groups (Odds Ratio [OR] 5.65, 95% confidence interval [CI] 1.42-22.52), those in urban areas (OR 2.8, 95% CI 1.01-7.74) those with higher socioeconomic status (OR 6.0; 95% CI 1.96-18.4).

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Section: Discussionmentioning

confidence: 87%

Prevalence and visual outcomes of cataract surgery and cataract surgical coverage in Sri Lanka: findings from the National Blindness and Visual Impairment Survey

et al. 2018

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“…A large proportion of those who had bilateral cataract surgery had URE suggesting the need for follow‐up care after cataract for the correction of refractive error. There are not many studies that reported on the burden of URE after cataract surgery in the elderly in residential care in India though the studies have reported on visual outcomes after cataract surgery in the community‐dwelling populations 32‐34 . URE was reported as the leading cause of visual impairment after cataract surgery in these studies ranging from 28.7% to 38.8%.…”

Section: Discussionmentioning

confidence: 99%

Uncorrected refractive errors for distance among the residents in 'homes for the aged' in South India–The Hyderabad Ocular Morbidity in Elderly Study (HOMES)

Marmamula

Barrenkala

Challa

et al. 2020

Ophthalmic Physiologic Optic

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Purpose: To investigate the prevalence and risk factors of Uncorrected Refractive Errors (URE) for distance in elderly residents in 'homes for the aged' in Hyderabad, India. Methods: Individuals aged ≥60 years and residing in 'homes for the aged' in Hyderabad, India for a minimum of 1 month and providing consent for participation were recruited. All participants underwent visual acuity assessment, refraction, slit lamp biomicroscopy, intraocular pressure measurement, fundus examination, and retinal imaging. Monocular presenting visual acuity was recorded using a logMAR chart. Objective and subjective refraction were performed, and best-corrected visual acuity was recorded. URE was defined as presenting visual acuity worse than 6/12 but improving to 6/12 or better with refraction. Univariable and multivariable logistic regression analyses were used to assess the risk factors associated with URE. Results: In total, 1 513 elderly participants were enumerated from 41 homes of which 1 182 participants (78.1%) were examined. The mean age of participants was 75.0 years (standard deviation 8.8 years; range: 60-108 years). 35.4% of those examined were men and 20.3% had no formal education. The prevalence of URE was 13.5% (95% CI: 11.5-15.5; n = 159). On applying multiple logistic regression analysis, compared to those living in private homes, the odds of URE were significantly higher among the elderly living in the aided homes (OR: 1.65; 95% CI: 1.11-2.43) and free homes (OR: 1.67; 95% CI: 1.00-2.80). As compared to those who reported having an eye examination in the last 3 years, the odds of URE were higher among those who never had an eye examination in the last three years (OR: 1.51; 95% CI: 1.07-2.14). Similarly, those who had unilateral cataract surgery (OR: 1.80; 95% CI: 1.10-2.93) or bilateral cataract surgery (1.69; 95% CI: 1.10-2.56) had higher odds of URE compared to those elderly who were not operated for cataract. Gender, self-report of diabetes, and education were not associated with URE. Conclusions: A large burden of URE was found among the residents in the 'homes for the aged' in Hyderabad, India which could be addressed with a pair of glasses. Over 40% of the residents never had an eye examination in the last three

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“…A recent large population based study amongst adults in southern India reiterated that correction of refractive errors is required to provide good visual recovery and achieve the benefit of cataract surgery. 32 Most of these free-surgeries in rural areas are done through outreach programs as part of the National Program for Control of Blindness (NPCB) activity where they are transported to the base hospital for surgeries and a few given one-time free spectacles six weeks after cataract surgery. Though it is mandatory to prescribe and provide spectacles free of cost to post-surgery to poor patients, we found that just about a quarter of patients were prescribed and provided spectacles.…”

Section: Discussionmentioning

confidence: 99%

Determinants of vision function related quality of life of patients undergoing unilateral cataract surgical services in charitable hospitals in India: a multicentre prospective cohort study

Kurian¹,

Vishwakarma²,

Deenadayalan³

et al. 2018

Int J Community Med Public Health

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Background: Cataract is the leading cause of avoidable blindness in developing world, including India. The objective of this study is to measure the changes in quality of life (VRQoL) after cataract surgery and identify the predictors of an improvement in these outcomes.Methods: A multi-center prospective, longitudinal cohort study was conducted. At baseline patients aged ≥18 years with first-eye cataract were interviewed about VRQoL. Six months’ later participants were re-interviewed at their residences. Multiple classification analysis (MCA) was performed to assess the variation in the intensities of mean change scores for general function, psychosocial impact and visual function with select factors.Results: The six-month follow-up rate was 87.3%. There was a significant improvement in visual acuity and VRQoL post-surgery. The mean general function, psychosocial impact and visual function scores were 34.6 (SD 10.9), 10.5 (SD 3.7) and 8.4 (SD 2.2) in the baseline and 15 (SD 5.5), 5 (SD 2.2) and 4.4 (SD 1.6) in the follow-up assessments, respectively. In MCA, patients prescribed spectacles post-surgery (β 0.137) and those from rural backgrounds (β 0.137) had the most impact on general function. Patients with complete follow-up visits had a relatively higher effect on the psychosocial impact (β 0.084) whereas patients from rural background and men had the most impact on the visual function scores (β 0.102 and 0.076) respectively.Conclusions:Cataract surgery is associated with meaningful improvements in VRQoL in general. The determinants of better VFQoL include regular and complete patient follow-up visits and prescription and provision of spectacles post-surgery.

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Outcomes of Cataract Surgery in Urban and Rural Population in the South Indian State of Andhra Pradesh: Rapid Assessment of Visual Impairment (RAVI) Project

Cited by 22 publications

References 28 publications

Prevalence and visual outcomes of cataract surgery and cataract surgical coverage in Sri Lanka: findings from the National Blindness and Visual Impairment Survey

Prevalence and visual outcomes of cataract surgery and cataract surgical coverage in Sri Lanka: findings from the National Blindness and Visual Impairment Survey

Uncorrected refractive errors for distance among the residents in 'homes for the aged' in South India–The Hyderabad Ocular Morbidity in Elderly Study (HOMES)

Determinants of vision function related quality of life of patients undergoing unilateral cataract surgical services in charitable hospitals in India: a multicentre prospective cohort study

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