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Br J Ophthalmol. 2018 Oct;102(10):1419-1424. doi: 10.1136/bjophthalmol-2017-311257. Epub 2018 Jan 4.

Population-based assessment of visual acuity outcomes following cataract surgery in Australia: the National Eye Health Survey.

Author information

1
Centre for Eye Research Australia Ltd, Royal Victorian Eye & Ear Hospital, East Melbourne, Victoria, Australia.
2
Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.
3
Indigenous Eye Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
4
Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore.

Abstract

AIM:

To assess the visual outcomes of cataract surgery among a national sample of non-Indigenous and Indigenous Australians.

METHODS:

This was a population-based study of 3098 non-Indigenous Australians (50-98 years) and 1738 Indigenous Australians (40-92 years), stratified by remoteness. A poor postoperative outcome in an eye that had undergone cataract surgery was defined as presenting distance visual acuity (PVA) <6/12-6/60, and a very poor outcome was defined as PVA <6/60. Effective cataract surgery coverage (eCSC; operated cataract and a good outcome (PVA ≥6/12) as a proportion of operable plus operated cataract) was calculated.

RESULTS:

The sampling weight adjusted cataract surgery prevalence was 19.8% (95% CI 17.9 to 22.0) in non-Indigenous Australians and 8.2% (95% CI 6.0 to 9.6) in Indigenous Australians. Among the non-Indigenous population, poor and very poor PVA outcomes were present in 18.1% and 1.9% of eyes, respectively. For Indigenous Australians, these values were 27.8% and 6.3%, respectively. The main causes of poor vision were refractive error (non-Indigenous=41.8%; Indigenous=41.9%) and coincident disease (non-Indigenous=43.3%; Indigenous=40.3%). The eCSC rates in the non-Indigenous and Indigenous populations were 88.5% (95% CI 85.2 to 91.2) and 51.6% (95% CI 42.4 to 60.7), respectively.

CONCLUSION:

Approximately half of eyes with a poor visual outcome postcataract surgery could be readily avoided through the appropriate refractive correction. The finding of a lower eCSC rate among Indigenous Australians suggests that improvements in access and quality of cataract services may be warranted in order to reduce cataract-related vision loss in the Indigenous population.

KEYWORDS:

epidemiology; public health

[Indexed for MEDLINE]

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