Objective: To assess the prevalence, surgical coverage rate and social burden rate of cataract blindness among adults aged ≥60 years in the suburban population of Nantong, Jiangsu, China. Methods: It was a population-based cross-section study. A census with individuals aged ≥60 years was conducted in two villages of the suburb area in Nantong from June to August, 2008. A total of 1 305 individuals received visual acuity and eye examinations. Lens and cataract operative status were evaluated by slit-lamp biomicroscopy. Multiple logistic regression analysis was employed to analyze the prevalence of cataract, cataract surgical coverage rate and cataract blindness social burden rate among different ages, genders, educational backgrounds, marital statuses and salary levels. The results in the suburb were compared to the urban and rural areas. Results: Among 1 305 individuals, 376 cases of cataract were found. The prevalence of cataract was 28.81%. The rate was higher in the aged, less educated and low salary persons (P<0.01). In 47 eyes with cataract surgery, 19.15% of eyes were treated by modern extra-capsular surgery and 38.30% received phacoemulsification. The rate of intraocular lens implantation was 57.45%. The cataract surgical coverage rate was 40.48% and the cataract blindness social burden rate was 3.22%. The cataract surgical coverage rate was higher in the primary-educational persons than illiterate persons (P<0.05). The cataract blindness social burden rate was higher in ≥80-year-old persons than ≥60-year-old persons (P<0.05) and lower in married persons than single persons (P<0.05). The cataract surgical coverage rate was lower in the suburb area than in the city area, while the cataract blindness social burden rate was opposite. The rate of postoperative presenting visual acuity and best-corrected visual acuity of over 0.7 was 14.89% and 23.40% in the operated eyes, respectively. The main causes of unfavorable postoperative visual acuity (<0.3) were retinal disorders, post-capsular opacity, corneal opacity, refractive errors and glaucoma. Conclusions: Cataract is the most common and important eye disease that may lead to blindness and severe visual impairment among adults aged 60 years or above in the suburb of Nantong City. The prevalence of cataract is related to age, education background and economy level. The cataract surgical coverage rate is low and the cataract blindness social burden rate is high. The first important task in blindness prevention is still the elimination of cataract blindness and the improvement of visual outcomes after cataract surgery. (Chin J Ophthalmol, 2017, 53: 514-521).
目的： 调查2008年江苏省南通市近郊区常住居民中60岁及以上人群中白内障患病率、白内障摘除术覆盖率、白内障盲人社会负担率。 方法： 以人群为基础的横断面调查。2008年6至8月在江苏省南通市近郊区2个自然村对1 305例60岁及以上人群进行视力、眼部检查，包括裂隙灯显微镜检查评价晶状体混浊程度和白内障摘除术情况。应用多元逻辑回归分析受检者不同年龄、性别、受教育程度、婚姻状况和收入对白内障患病率、白内障摘除术覆盖率、白内障盲人社会负担率的影响，并与南通市城区和农村地区的调查结果相比较。 结果： 1 305例受检者中，发现白内障376例，患病率为28.81%。高龄、受教育程度低以及收入低的人群白内障患病率明显增高（P<0.01）。在施行白内障摘除术的47只眼中，采用现代囊外摘除联合人工晶状体植入术9只眼（19.15%），白内障超声乳化吸除术联合人工晶状体植入术18只眼（38.30%），人工晶状体植入率为57.45%。白内障摘除术覆盖率为40.48%，白内障盲人社会负担率为3.22%。与文盲人群相比，小学人群白内障摘除术覆盖率增加（P<0.05）。80~岁人群较60~岁人群白内障盲人社会负担率高（P<0.05）；已婚人群较未婚人群白内障盲人社会负担率低（P<0.05）。南通市近郊区老年人群白内障盲人手术覆盖率低于城区，盲人社会负担率高于城区。术后日常生活视力和最佳矫正视力≥0.7的眼分别占总数的14.89%和23.40%，术后视力差（<0.3）的主要原因是视网膜疾病、晶状体后囊膜混浊、角膜混浊、屈光不正和青光眼。 结论： 白内障是江苏省南通市近郊人口中最常见的致盲眼病，其患病率与年龄、受教育程度及经济水平有关。白内障摘除术覆盖率较低，而白内障社会负担率较重，防盲工作的首要任务应为努力提高白内障摘除术的数量和质量。（中华眼科杂志，2017，53：514-521）.
Keywords: Cataract; Cataract extraction; Cost of illness; Prevalence.