Blindness, cataract surgery and mortality in Ethiopia

Br J Ophthalmol. 2016 Sep;100(9):1157-62. doi: 10.1136/bjophthalmol-2015-308328. Epub 2016 Jun 7.

Abstract

Purpose: To examine the relationships between blindness, the intervention of cataract surgery and all-cause mortality in a rural Ethiopian population.

Design: Population-based, interventional prospective study.

Methods: Community-based detection methods identified blind Ethiopian persons from two selected kebeles in Amhara region, Ethiopia. Data from 1201 blind patients were collected-628 cataract-blind and 573 blind from other conditions. Free cataract surgery was provided for consenting, cataract-blind patients. Follow-up surveys were conducted after 12 months (±1 month)-the main outcome measure for this report is all-cause mortality at 1 year.

Results: During the follow-up period, 110 persons died from the selected population (mortality 9.2%), which consisted of those cataract-blind patients who received cataract surgery (N=461), cataract-blind patients who did not receive surgery (N=167) and all non-cataract-blind patients (N=573). Of the 461 patients who received cataract surgery, 44 patients died (9.5%). Of the 740 patients who did not receive surgery, 66 died (8.9%)-28 patients from the cohort of cataract-blind patients who did not receive surgery (16.8%) and 38 patients from the cohort of non-cataract blind (6.6%). Subgroup analysis revealed significantly increased odds of mortality for cataract-blind patients over 75 years of age who did not receive surgery and for unmarried patients of all age groups.

Conclusions: In this population, mortality risk was significantly elevated for older cataract-blind patients when compared with non-cataract-blind patients-an elevation of risk that was not noted in an age-matched cohort of cataract-blind patients who underwent cataract surgery as early as 1-year follow-up.

Keywords: Lens and zonules; Public health; Treatment Surgery; Vision.

Publication types

  • Multicenter Study

MeSH terms

  • Age Distribution
  • Aged
  • Blindness / epidemiology*
  • Blindness / etiology
  • Cataract / complications*
  • Cataract Extraction*
  • Cross-Sectional Studies
  • Ethiopia / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Prevalence
  • Prospective Studies
  • Rural Population / statistics & numerical data*
  • Sex Distribution
  • Survival Rate / trends
  • Visual Acuity