Prevalence and Outcomes of Cataract Surgery in Brazil: The São Paulo Eye Study

Purpose To investigate the prevalence and visual acuity (VA) outcomes of cataract surgery in a low- to middle-income population in Sao Paulo, Brazil. Design Population-based, cross-sectional study. Methods Cluster sampling was used in randomly selecting those ≥50 years old for VA measurement, refraction, and ocular examination. Participants were queried as to the year and type of facility for previous cataract surgery. Surgical procedure and evidence of surgical complications were noted. Main outcome measures were presenting and best-corrected vision, and the principal cause for eyes presenting with VA ≤20/40. Results A total of 4,224 eligible persons were enumerated and 3,678 (87.1%) were examined. The prevalence of cataract surgery was 6.28% (95% confidence interval [CI], 5.29% to 7.27%). Surgical coverage for presenting VA 20/40, 28.1% with VA 20/40 to 20/63, 14.2% with VA Conclusions Cataract surgery has increased in Sao Paulo, but many remain visually impaired/blind because of cataract. Refractive error and other causes of impairment are common in cataract-operated eyes. Emphasis on the quality of VA outcomes and sustained government subsidy to provide access to affordable modern cataract surgery are needed.