Population based outcomes of cataract surgery in three tribal areas of Andhra pradesh, India: Risk factors for poor outcomes

Rohit C. Khanna, Srinivasa Reddy Pallerla, Shiva Shankar Eeda, Bala Krishna Gudapati, Sandra Cassard, Padmaja Kumari Rani, Ghanshyam Palamaner Subash Shantha, Subhabrata Chakrabarti, Oliver D Schein

Research output: Contribution to journalArticle

Abstract

Purpose: To report visual outcomes and risk factors for poor outcomes of cataract surgery in three Integrated Tribal Development Agency (ITDA) areas of Andhra Pradesh, India. Methods and Results: Using validated Rapid Assessment of Avoidable Blindness (RAAB) methodology, a population based cross-sectional study, was conducted in three ITDA areas. A two-stage sampling procedure was used to select 7281 participants aged 50 years and above. Vision assessment using a tumbling E chart and standard ocular examinations were completed. Visual outcomes and risk factors for poor outcomes were assessed among subjects undergoing cataract surgery (1548 eyes of 1124 subjects). Mean age at surgery was 67±8 years; Among the operated eyes, presenting visual acuity (PVA) and best corrected visual acuity (BCVA) worse than 6/18 was seen in 492 (31.8%; 95% CI, 29.5-34.2%) and 298 eyes (19.3%; 95% CI, 17.3-21.3%), respectively. Similarly, PVA and BCVA worse than 6/60 was seen in 219 (14.1%; 95% CI, 12.4-16%) and 147 eyes (9.5%; 95% CI, 8.1-11.1%), respectively. When either eye was taken into consideration, the PVA and BCVA worse than 6/18 was seen in 323 (20.1%; 95% CI, 18.9-23%) and 144 subjects (9.3%; 95% CI, 7.9-10.9%), respectively. PVA and BCVA worse than 6/60 was seen in 74 (4.8%; 95% CI, 3.8-6%) and 49 subjects (3.2%; 95% CI, 2.4-4.2%), respectively. Posterior capsular opacification was seen in 51 of 1316 pseudophakic eyes (3.9%; 95% CI, 2.9-5.1%). In multivariable analysis among pseudophakic subjects with PVA worse than 6/18, increasing age (p = 0.002) and undergoing free surgery (p = 0.05) were independent risk factors. Undergoing surgery before 2005 (p = 0.05) and being illiterate (p = 0.05) were independent risk factors for BCVA worse than 6/18. Conclusions: There are changing trends with improved outcomes in cataract surgery among these tribal populations of India. However, post-operative refractive error correction remains an issue, especially for those undergoing free surgeries.

Original languageEnglish (US)
Article numbere35701
JournalPLoS One
Volume7
Issue number5
DOIs
StatePublished - May 2 2012

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cataract
Cataract
Surgery
Visual Acuity
India
risk factors
surgery
eyes
Population
Barreling
blindness
Error correction
cross-sectional studies
Refractive Errors
Blindness
Sampling
Cross-Sectional Studies
methodology

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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Population based outcomes of cataract surgery in three tribal areas of Andhra pradesh, India : Risk factors for poor outcomes. / Khanna, Rohit C.; Pallerla, Srinivasa Reddy; Eeda, Shiva Shankar; Gudapati, Bala Krishna; Cassard, Sandra; Rani, Padmaja Kumari; Shantha, Ghanshyam Palamaner Subash; Chakrabarti, Subhabrata; Schein, Oliver D.

In: PLoS One, Vol. 7, No. 5, e35701, 02.05.2012.

Research output: Contribution to journalArticle

Khanna, Rohit C. ; Pallerla, Srinivasa Reddy ; Eeda, Shiva Shankar ; Gudapati, Bala Krishna ; Cassard, Sandra ; Rani, Padmaja Kumari ; Shantha, Ghanshyam Palamaner Subash ; Chakrabarti, Subhabrata ; Schein, Oliver D. / Population based outcomes of cataract surgery in three tribal areas of Andhra pradesh, India : Risk factors for poor outcomes. In: PLoS One. 2012 ; Vol. 7, No. 5.
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abstract = "Purpose: To report visual outcomes and risk factors for poor outcomes of cataract surgery in three Integrated Tribal Development Agency (ITDA) areas of Andhra Pradesh, India. Methods and Results: Using validated Rapid Assessment of Avoidable Blindness (RAAB) methodology, a population based cross-sectional study, was conducted in three ITDA areas. A two-stage sampling procedure was used to select 7281 participants aged 50 years and above. Vision assessment using a tumbling E chart and standard ocular examinations were completed. Visual outcomes and risk factors for poor outcomes were assessed among subjects undergoing cataract surgery (1548 eyes of 1124 subjects). Mean age at surgery was 67±8 years; Among the operated eyes, presenting visual acuity (PVA) and best corrected visual acuity (BCVA) worse than 6/18 was seen in 492 (31.8{\%}; 95{\%} CI, 29.5-34.2{\%}) and 298 eyes (19.3{\%}; 95{\%} CI, 17.3-21.3{\%}), respectively. Similarly, PVA and BCVA worse than 6/60 was seen in 219 (14.1{\%}; 95{\%} CI, 12.4-16{\%}) and 147 eyes (9.5{\%}; 95{\%} CI, 8.1-11.1{\%}), respectively. When either eye was taken into consideration, the PVA and BCVA worse than 6/18 was seen in 323 (20.1{\%}; 95{\%} CI, 18.9-23{\%}) and 144 subjects (9.3{\%}; 95{\%} CI, 7.9-10.9{\%}), respectively. PVA and BCVA worse than 6/60 was seen in 74 (4.8{\%}; 95{\%} CI, 3.8-6{\%}) and 49 subjects (3.2{\%}; 95{\%} CI, 2.4-4.2{\%}), respectively. Posterior capsular opacification was seen in 51 of 1316 pseudophakic eyes (3.9{\%}; 95{\%} CI, 2.9-5.1{\%}). In multivariable analysis among pseudophakic subjects with PVA worse than 6/18, increasing age (p = 0.002) and undergoing free surgery (p = 0.05) were independent risk factors. Undergoing surgery before 2005 (p = 0.05) and being illiterate (p = 0.05) were independent risk factors for BCVA worse than 6/18. Conclusions: There are changing trends with improved outcomes in cataract surgery among these tribal populations of India. However, post-operative refractive error correction remains an issue, especially for those undergoing free surgeries.",
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T1 - Population based outcomes of cataract surgery in three tribal areas of Andhra pradesh, India

T2 - Risk factors for poor outcomes

AU - Khanna, Rohit C.

AU - Pallerla, Srinivasa Reddy

AU - Eeda, Shiva Shankar

AU - Gudapati, Bala Krishna

AU - Cassard, Sandra

AU - Rani, Padmaja Kumari

AU - Shantha, Ghanshyam Palamaner Subash

AU - Chakrabarti, Subhabrata

AU - Schein, Oliver D

PY - 2012/5/2

Y1 - 2012/5/2

N2 - Purpose: To report visual outcomes and risk factors for poor outcomes of cataract surgery in three Integrated Tribal Development Agency (ITDA) areas of Andhra Pradesh, India. Methods and Results: Using validated Rapid Assessment of Avoidable Blindness (RAAB) methodology, a population based cross-sectional study, was conducted in three ITDA areas. A two-stage sampling procedure was used to select 7281 participants aged 50 years and above. Vision assessment using a tumbling E chart and standard ocular examinations were completed. Visual outcomes and risk factors for poor outcomes were assessed among subjects undergoing cataract surgery (1548 eyes of 1124 subjects). Mean age at surgery was 67±8 years; Among the operated eyes, presenting visual acuity (PVA) and best corrected visual acuity (BCVA) worse than 6/18 was seen in 492 (31.8%; 95% CI, 29.5-34.2%) and 298 eyes (19.3%; 95% CI, 17.3-21.3%), respectively. Similarly, PVA and BCVA worse than 6/60 was seen in 219 (14.1%; 95% CI, 12.4-16%) and 147 eyes (9.5%; 95% CI, 8.1-11.1%), respectively. When either eye was taken into consideration, the PVA and BCVA worse than 6/18 was seen in 323 (20.1%; 95% CI, 18.9-23%) and 144 subjects (9.3%; 95% CI, 7.9-10.9%), respectively. PVA and BCVA worse than 6/60 was seen in 74 (4.8%; 95% CI, 3.8-6%) and 49 subjects (3.2%; 95% CI, 2.4-4.2%), respectively. Posterior capsular opacification was seen in 51 of 1316 pseudophakic eyes (3.9%; 95% CI, 2.9-5.1%). In multivariable analysis among pseudophakic subjects with PVA worse than 6/18, increasing age (p = 0.002) and undergoing free surgery (p = 0.05) were independent risk factors. Undergoing surgery before 2005 (p = 0.05) and being illiterate (p = 0.05) were independent risk factors for BCVA worse than 6/18. Conclusions: There are changing trends with improved outcomes in cataract surgery among these tribal populations of India. However, post-operative refractive error correction remains an issue, especially for those undergoing free surgeries.

AB - Purpose: To report visual outcomes and risk factors for poor outcomes of cataract surgery in three Integrated Tribal Development Agency (ITDA) areas of Andhra Pradesh, India. Methods and Results: Using validated Rapid Assessment of Avoidable Blindness (RAAB) methodology, a population based cross-sectional study, was conducted in three ITDA areas. A two-stage sampling procedure was used to select 7281 participants aged 50 years and above. Vision assessment using a tumbling E chart and standard ocular examinations were completed. Visual outcomes and risk factors for poor outcomes were assessed among subjects undergoing cataract surgery (1548 eyes of 1124 subjects). Mean age at surgery was 67±8 years; Among the operated eyes, presenting visual acuity (PVA) and best corrected visual acuity (BCVA) worse than 6/18 was seen in 492 (31.8%; 95% CI, 29.5-34.2%) and 298 eyes (19.3%; 95% CI, 17.3-21.3%), respectively. Similarly, PVA and BCVA worse than 6/60 was seen in 219 (14.1%; 95% CI, 12.4-16%) and 147 eyes (9.5%; 95% CI, 8.1-11.1%), respectively. When either eye was taken into consideration, the PVA and BCVA worse than 6/18 was seen in 323 (20.1%; 95% CI, 18.9-23%) and 144 subjects (9.3%; 95% CI, 7.9-10.9%), respectively. PVA and BCVA worse than 6/60 was seen in 74 (4.8%; 95% CI, 3.8-6%) and 49 subjects (3.2%; 95% CI, 2.4-4.2%), respectively. Posterior capsular opacification was seen in 51 of 1316 pseudophakic eyes (3.9%; 95% CI, 2.9-5.1%). In multivariable analysis among pseudophakic subjects with PVA worse than 6/18, increasing age (p = 0.002) and undergoing free surgery (p = 0.05) were independent risk factors. Undergoing surgery before 2005 (p = 0.05) and being illiterate (p = 0.05) were independent risk factors for BCVA worse than 6/18. Conclusions: There are changing trends with improved outcomes in cataract surgery among these tribal populations of India. However, post-operative refractive error correction remains an issue, especially for those undergoing free surgeries.

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