Cataract surgical coverage and barriers in the Republic of Moldova

Abstract

Aim: To describe Cataract Surgical Coverage (CSC) and barriers in the Republic of Moldova Methods and Materials: Cataract Surgical Coverage, both for “eyes” as well as “persons”, was calculated from RAAB survey conducted in 111 communities (towns/ villages) in the Republic of Moldova. A total of 3877 subjects out of the 3885 eligible subjects were examined. Data collection was done in selected clusters by house to house visits using a standard methodology of examination. Visual acuity, cause of vision loss, history of cataract surgery and cause of poor vision (if less than 6/60) were assessed. Results: The blindness prevalence in the Republic of Moldova is 1.4% (95%CI 1.0-1.8) -13.693 people, the major causes of blindness beeing untreated cataract (58.2%), The age and sex adjusted prevalence of cataract responsible for bilateral blindness (vision less than 3/60 in better eye) among the study population was 0.65% (males 0.54%, females 0.72%). The age and sex adjusted cataract surgical coverage (CSC) for persons with cataract responsible for vision less than 3/60 was 77.8% with similar rates among both sexes. This study showed that financial problem (mostly indirect costs as travel expenses, etc) was the most important barrier (28,6%) to uptake cataract surgery. Conclusions: The RAAB survey in the Republic of Moldova established that untreated cataract is the major cause of avoidable blindness in this area and the CSC increase with worsening of visual acuity, suggesting that persons undergo surgery in the later stages of cataract.