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Study of Cataract Outcomes and Up-Take of Services (SCOUTS) in the Caring Is Hip Project, Report 1

Dennis S. C. Lam, MBBS, MD, FRCOphth, FHKAM(Ophth); Nathan G. Congdon, MD, MPH; Srinivas K. Rao, MD, FRCSEd; Hoi Fan, MBBS, MRCSEd, MMed(Ophth); Yingpeng Liu, MD; Lishan Zhang, MD; Xiaofang Lin, MD; Kai Choi, PhD; Zhongren Zheng, BA; Wenzhong Huang, MD; Zhongxia Zhou, MD; Chi Pui Pang, DPhil

Arch Ophthalmol. 2007;125(11):1539-1544. Published online October 22, 2007 (doi:10.1001/archophthalmol.125.11.eeb70013).

Objective  To study the visual acuity and astigmatism of persons undergoing cataract extraction by local surgeons in rural China.

Methods  Visual acuity, keratometry, and refraction were measured 10 to 14 months postoperatively for all cataract cases during 4 months in Sanrao, China.

Results  Among 313 eligible subjects, 242 (77%) could be contacted, of whom 176 (73%) were examined. Of those who were examined, mean ± SD age was 69.3 ± 10.5 years, 66.5% were female, 35 had been operated on bilaterally at Sanrao, and 85.2% had a preoperative presenting visual acuity of 6/60 or worse. Presenting and best-corrected postoperative acuity in the eye that was operated on were 6/18 or better in 83.4% and 95.7%, respectively. Among 27 fellow eyes operated on elsewhere, 40.7% had a presenting acuity of 6/18 or better and 40.7% were blind (P < .001). Mean ± SD postoperative astigmatism did not differ between 211 eyes that were operated on (–1.13 ± 0.84 diopters) and 109 eyes that were not (–1.13 ± 1.17 diopters; P = .27). Presence of operative complications (8.5%) and older age were associated with worse vision; bilateral surgery was associated with better vision.

Conclusions  These results confirm the effectiveness of skill transfer in this setting, with superior outcomes to most studies in rural Asia and to eyes in this cohort operated on at other facilities.

Author Affiliations: Department of Ophthalmology and Visual Sciences (Drs Lam, Congdon, Rao, Fan, and Pang and Mr Zheng) and Centre for Epidemiology and Biostatistics, School of Public Health (Dr Choi), The Chinese University of Hong Kong; Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou (Drs Lam, Congdon, Rao, Liu, Zhou, and Pang); and Sanrao Village Hospital, Sanrao, China (Drs Zhang, Lin, and Huang).

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