Physicians successfully trained to perform cataract surgery in rural China

Patients in rural China who received cataract surgery from specially trained non-ophthalmologists had improved vision 10 to 14 months following surgery, according to an article that will appear in the November 2007 print issue of Archives of Ophthalmology.

This article was released along with articles from more than 200 other journals participating in a Global Theme Issue on the theme of Poverty and Human Development, coordinated by the Council of Science Editors. Presentations based on some of the articles in this Global Theme Issue will be webcast live from the National Institutes of Health (http://videocast.nih.gov/summary.asp?/live=6239).

After six months of intensive training, two local physicians who had not previously performed eye surgery operated on 313 patients in 2005. Dennis S. C. Lam, M.B.B.S., M.D., of the Chinese University of Hong Kong, and colleagues conducted follow-up examinations with 176 patients. “More than 85 percent of the eyes in this study were blind prior to surgery, and nearly 96 percent had best-corrected visual acuity of 6/18 or better, a visual outcome identified by the World Health Organization as indicative of ‘good' results for cataract surgery,” the authors write. ‘These results confirm the effectiveness of skill transfer in this setting, with superior outcomes to most studies in rural Asia and to eyes in this cohort operated on at other facilities.'

In a second paper based on the same study, Nathan G. Congdon, M.D., M.P.H., also of the Chinese University of Hong Kong, and colleagues determined that although 87 percent (151 of 174 examined patients) of the patients' vision could be further improved with glasses, only 53 patients (35 percent) accepted prescriptions, with most citing a lack of perceived need. In addition, only 48 percent of patients opted to have surgery on their second eye; most refused because of cost. “Programs to improve service uptake should focus on reading glasses and cost-reduction strategies such as tiered pricing,” the authors conclude.

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