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Wednesday, October 24, 2007 : 0945 Hrs

Sci. & Tech.
Physicians successfully trained to perform cataract surgery

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,' according
to Eurekalert, the news service of the American Association for the Advancement 
of Science.

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

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