摘要目的 调查云南省高海拔多民族聚居区≥40岁人群白内障手术负荷率、手术覆盖率及盲人社会负担率.方法 2008年2-4月选取云南省贡山县4个乡镇常住居民采用整群抽样方法进行调查,包括问卷调查、预调查、视力检查、眼压测量、裂隙灯显微镜检查及眼底检查.白内障诊断标准采用LOCSⅢ诊断系统.以较好眼最佳矫正视力＜0.05(标准A)和较好眼日常生活视力＜0.1(标准B)为盲的标准分别计算白内障手术负荷率、手术覆盖率、盲人社会负担率.以优势比比较不同年龄、性别、职业、民族、居住地海拔、文化程度、经济收入等因素间的差异.结果 调查点人群受检率为90.3％( 1116/1236).≥40岁人群年龄相关性白内障患病率为23.8％.以标准A计算,白内障盲人社会负担率为1.3％,手术覆盖率为50.0％,手术负荷率为8.2％；以标准B计算,分别为3.6％、25.0％和12.9％.在≥70岁人群、女性、高海拔居住地和文盲者中,白内障盲人社会负担率和白内障手术负荷率较高,而手术覆盖率较低.结论 云南省贡山县白内障盲人所造成的社会负担较重,老龄、文盲者患病率较高.

abstractsObjective To estimate the prevalence of cataract and its surgical coverage rate together with the burden related to bilateral cataract-blindness,among adults aged 40 or above in Gongshan county of Yunnan province and to evaluate the current cataract status and the efficacy of local cataract prevention program.Methods Cluster sampling was used.The protocol consisted of personal interview,pilot study,visual acuity checking,measuring the intraocular pressure; slit lamp microscopy and the fundus of the eye examination etc.Cataract was graded clinically using the Lens Opacity Classification System (LOCS) ]Ⅲ.Bilateral cataract-blindness burden,bilateral cataractblindness burden and cataract surgical coverage rate were calculated respectively,using two different criteria.Odds ratios (OR) were compared among different groups regarding age,gender,education,ethnic group and altitude of living area.Results Among the 1236 eligible residents,1116 (90.3％)were enrolled in the present study.The prevalence of cataract was 23.8％ among adults aged 40 or order.When the bilateral best refractive vision ＜3/60 was defined as the blindness criterion,the bilateral cataract-blindness burden showed as 1.3％,and cataract blindness surgical coverage rate was 50.0％.When the bilateral presenting vision ＜ 6/60 was defined as the blindness criterion,the bilateral cataract-blindness burden was 25.0％,and cataract blindness surgical coverage rate was 12.9％.The cataract surgical coverage rates were much lower and the bilateral cataract-blindness burden much higher in women,illiterates,living in high altitude areas and those who were aged 70 or above.Conclusion Cataract blindness was a serious public health problem in aged individuals and illiteracy in the residents of the studied areas.Poor prevention programs on cataract called for urgent action to be taken.