Cataract surgical coverage remains lower in women

Lewallen, Susan; Mousa, Ahmed; Bassett, Ken; Courtright, Paul

doi:10.1136/bjo.2008.140301

Cited by 137 publications

(112 citation statements)

References 32 publications

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“…From the results of bivariable as well as multivariable logistic regression model, we have noticed that, though not significant, women had higher odds of prevalence of CS; OR: 1.21 (95% CI: 0.96, 1.54) (p=0.115) (Table 5), which means that a noticeable improvement has occurred in terms of access to the cataract surgical services by women recently thereby suggesting that the scenario has changed significantly from past situation where lower female access to cataract services was reported. 18,[20][21][22] Even though our finding is in accordance with a previous report from Nepal; OR: 1.30, (95% CI: 0.90, 1.80), however, further studies are warranted to confirm this finding. 23 There exists an association between presence of diabetes and CS both in bivariable and multivariable analysis.…”

Section: Discussionsupporting

confidence: 58%

Prevalence and determinants of cataract surgical coverage in India: findings from a population-based study

Balasubramaniam

Ahmed

Ramani

2017

Int J Community Med Public Health

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Background: Cataract is the leading cause of avoidable blindness in most parts of developing world, including India. The objectives were to assess cataract surgical coverage (CSC) and investigate the determinants for CSC among people aged 50 years or older in India.Methods: A population-based, cross-sectional survey was conducted to include 2023 residents aged ≥50 years old from 72 clusters of 20 districts in six states from various parts of India. Presenting visual acuity (VA), history of cataract surgery and operable cataract were assessed by trained professionals. Prevalence of CSC and factors influencing cataract surgery (CS) were studied in the multivariable logistic regression model. A two-sided p-value of <0.05 was considered to be statistically significant.Results: Cataract surgery was done in 478 (23.6%) people in both eyes. Using VA<6/18 cut-off, the CSC was estimated as 67.2% in persons. In LR model, increased age was significantly associated with increased CS (P<0.0001). The odds of prevalence of CS was significantly lower in Uttar Pradesh; adjusted Odds Ratio (OR), 0.59; (95% CI: 0.36-0.95; p=0.032) and in persons with diabetes; OR: 0.61; (95% CI: 0.38-0.94; p=0.028).Conclusions: Cataract surgical need is currently not being met in India and the increasing prevalence of diabetes is an additional major challenge in addressing the gap in CS.

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Section: Discussionsupporting

confidence: 58%

Prevalence and determinants of cataract surgical coverage in India: findings from a population-based study

Balasubramaniam

Ahmed

Ramani

2017

Int J Community Med Public Health

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“…20 Some factors should be considered in this regard. Similar to some studies, [21][22][23] we also believe that women's access to health services has improved in recent decades; therefore, younger women now utilize such services as men do. However, older women have less utilized health and medical care services.…”

Section: Discussionmentioning

confidence: 51%

Visual impairment in the 40- to 64-year-old population of Shahroud, Iran

Hashemi

Khabazkhoob

Emamian

et al. 2012

Eye

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Purpose To determine the prevalence of visual impairment by age and gender in Shahroud. Methods Using random cluster sampling, 6311 Shahroud inhabitants who were between 40 and 64 years old were invited for ophthalmological examinations. Visual acuity worse than 0.5 LogMAR (20/60) and 1.3 LogMAR (20/ 400) in the better eye was regarded as low vision and blindness, respectively. The cause of blindness was determined by an ophthalmologist and in a person with more than one cause, the most correctable cause was regarded as the main cause. Results This study was conducted on 5190 participants (response rate: 82.2%). On the basis of presenting visual acuity, the prevalence of low vision and blindness was found to be 1.8% (95% confidence interval (CI): 1.4-2.10) and 0.5% (95% CI: 0.3-0.7), respectively. Based on corrected vision, these values were 0.5% (95% CI: 0.3-0.7) and 0.3% (95% CI: 0.1-0.4), respectively. Visual impairment increased with age in women (Po0.001). Uncorrected refractive errors (63.9%), cataract (20.2%), and amblyopia (5.9%) were the most common causes of visual impairment based on presenting vision. Based on corrected vision, however, cataract (42.5%), amblyopia (12.5%), and retinitis pigmentosa (7.5%) were the most common causes of visual impairment. Conclusion Although the prevalence of visual impairment in the city of Shahroud was determined to be lower than two previous studies in the country, correction of refractive errors and cataract could minimize the rate of visual impairment in this population as they were shown to comprise 85% of the causes of visual impairment. The elderly women need to receive more attention.

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“…This difference reflects a higher incidence of advanced diabetic eye disease in male diabetics and gender inequalities with regard to access to healthcare in the region. 12,13 Many of the patients came from other countries in sub-Saharan Africa, from as far afield as Ghana and Zimbabwe. Male patients from these countries were more likely to be able to access the resources to fly to Tanzania.…”

Section: Discussionmentioning

confidence: 99%

Bevacizumab as an adjunct to vitreoretinal surgery for diabetic retinopathy in East Africa

Guthrie

Hall

Dhalla

et al. 2013

Eye

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Purpose The purpose of this study is to evaluate the efficacy of preoperative intravitreal bevacizumab (IVB) for improving outcomes in vitrectomy for diabetic retinopathy-related non-clearing vitreous haemorrhage and/or tractional retinal detachment. Methods Medical record from patients undergoing vitrectomy for proliferative diabetic retinopathy (PDR) were retrospectively analysed (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011). From 2007, IVB (1.25 mg 2-4 days before operating) was used on all eyes. Eyes receiving IVB were compared with those that did not receive IVB. Intraoperative complications, reoperation rates, and final visual acuity were the core outcome measures. Results Data were analysed for 88 patients (101 eyes). In all, 41 (41%) patients had received IVB, whereas 60 (59%) patients had not. Significant intraoperative haemorrhage occurred in six eyes (10%) in the non-IVB group and in one (2.4%) IVB eyes (P ¼ 0.24). Silicon oil was used in 29 (48%) non-IVB eyes and in 11 (27%) IVB eyes (P ¼ 0.03). The non-IVB eyes underwent significantly more vitreoretinal reoperations (P ¼ 0.01) and were significantly more likely to lose two or more lines of vision at the final follow-up (P ¼ 0.03). The numbers needed to treat (NNT) blindness (o3/60) was four for non-IVB eyes and two for the IVB group. Conclusions IVB reduces surgical complications, the use of silicon oil, and the need for further retinal surgery. The NNT to restore useful vision (Z3/60) to a blind eye were significantly lower in the IVB group. Vitreoretinal surgery for the complications of PDR is effective in an East African context, and IVB should be considered a valuable adjunct.

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Cataract surgical coverage remains lower in women

Cited by 137 publications

References 32 publications

Prevalence and determinants of cataract surgical coverage in India: findings from a population-based study

Prevalence and determinants of cataract surgical coverage in India: findings from a population-based study

Visual impairment in the 40- to 64-year-old population of Shahroud, Iran

Bevacizumab as an adjunct to vitreoretinal surgery for diabetic retinopathy in East Africa

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