ABSTRACT $t?e=#G
Purpose: To quantify the prevalence of cataract, the outcomes kF7Al]IgT
of cataract surgery and the factors related to @T T[H*,
unoperated cataract in Australia. d":{a6D*d
Methods: Participants were recruited from the Visual J)+eEmrU
Impairment Project: a cluster, stratified sample of more than :H7 "W<
5000 Victorians aged 40 years and over. At examination qd ZYaS ~
sites interviews, clinical examinations and lens photography c}cboe2
were performed. Cataract was defined in participants who EORAx
had: had previous cataract surgery, cortical cataract greater l{yPO@ut`F
than 4/16, nuclear greater than Wilmer standard 2, or w,$1 7+]3
posterior subcapsular greater than 1 mm2. [HfFC3U
Results: The participant group comprised 3271 Melbourne 1gr jK.x
residents, 403 Melbourne nursing home residents and 1473 w[_Uv4M
rural residents.The weighted rate of any cataract in Victoria ivk|-C'\
was 21.5%. The overall weighted rate of prior cataract =+WFx3/
surgery was 3.79%. Two hundred and forty-nine eyes had /J:j
'6
had prior cataract surgery. Of these 249 procedures, 49 D.}b<kDD
(20%) were aphakic, 6 (2.4%) had anterior chamber &3. 8i%
intraocular lenses and 194 (78%) had posterior chamber ];YOP%2
intraocular lenses.Two hundred and eleven of these operated SfR_#"Uu
eyes (85%) had best-corrected visual acuity of 6/12 or gS 3&,^
better, the legal requirement for a driver’s license.Twentyseven cPS
pPx
(11%) had visual acuity of less than 6/18 (moderate r+crE %-
vision impairment). Complications of cataract surgery C09@2M'
caused reduced vision in four of the 27 eyes (15%), or 1.9% R!ij CF\
of operated eyes. Three of these four eyes had undergone FS0SGBo
intracapsular cataract extraction and the fourth eye had an 7y&`H
opaque posterior capsule. No one had bilateral vision $I%]jAh6
impairment as a result of cataract surgery. Surprisingly, no
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particular demographic factors (such as age, gender, rural !xSGZD=AD
residence, occupation, employment status, health insurance e"Z~%,^A
status, ethnicity) were related to the presence of unoperated `B~%TEvMh
cataract. {^F_b% a4z
Conclusions: Although the overall prevalence of cataract is +9t@eHJT1
quite high, no particular subgroup is systematically underserviced 3-0Y<++W3>
in terms of cataract surgery. Overall, the results of O\?ei+(H7
cataract surgery are very good, with the majority of eyes q :gH`5N
achieving driving vision following cataract extraction. !#QD;,SE+
Key words: cataract extraction, health planning, health PeOgXg)L`z
services accessibility, prevalence \VW.>@s~
INTRODUCTION '`n\YO.N
Cataract is the leading cause of blindness worldwide and, in lxbZM9A2
Australia, cataract extractions account for the majority of all zT@vji%Y
ophthalmic procedures.1 Over the period 1985–94, the rate \|kU{d0
of cataract surgery in Australia was twice as high as would be Kgcg:r:
expected from the growth in the elderly population.1 ~be&T:7.
Although there have been a number of studies reporting -1[ri8t;nV
the prevalence of cataract in various populations,2–6 there is Z|u_DaSrr|
little information about determinants of cataract surgery in r(RJ&