Background Despite its affordability and accessibility and improved quality, cataract surgical service for those with moderate vision loss is quite low in the urban regions of China. The current study aimed to understand the perceptions for the utilization of cataract surgical services and their outcomes in a population of acceptors and non-acceptors of cataract surgery in urban Beijing.
Methods From a community-based screening program, individuals with a presenting visual acuity of less than 6/18 due to cataract were informed about the possibilities for surgical treatment. The persons were interviewed and re-examined 24 months after the initial detection screening. Visual function and vision-related quality of life were assessed in both those who had received and had not received surgery. To gain a better understanding of reasons for not choosing surgery, a standard questionnaire was used.
Results  A total of 4,755 residents aged 50 years or older attended the screening program. Among them, 158 were diagnosed with cataract and were informed of the possibility of having a cataract operation with the possible benefits of the procedure. Of the 158 that were identified with cataract, 128 (81.0%) participated in the follow up study. At the time of follow-up, 35 (27.3%) had undergone cataract surgery. The main reasons given for not going for cataract surgery was a general persuasion that there was no perceived need (50.9%) followed by “too old” (18.9%) and a general worry about the quality of surgery (9.4%). Only 1 (1.9%) person cited the cost as the main reason for not seeking surgery. Those who chose to undergo cataract surgery had a higher education level than those who did not seek surgery (OR=2.9; 95%CI: 1.2, 6.8). People without religion were more likely to have surgery than those with religion (OR=10.34; 95%CI: 1.3, 82.5). For those who received surgery, they reported a better peripheral vision, mobility and social psychology status, but no difference of general visual function or vision related quality of life.
Conclusions The present study suggested that in China’s urban centers amongst persons with moderate vision loss due to cataract, there was still a low acceptance rate of cataract surgery. We found that this was mainly due to people’s high tolerance for visual impairment. Cost was not a determining factor.