Global challenges face cataract surgeons in the near future

With the world's population getting older and the rate of blindness increasing in regard to that aging population, cataract surgeons worldwide are facing some clinical challenges in the years ahead, according to Stephen A. Obstbaum, MD, of United States.

Dr. Obstbaum outlined the challenges that cataract surgeons need to address if world blindness is to be controlled. Emanuel Rosen, MD, of the University of Manchester, England, presented Dr. Obstbaum's talk Tuesday at the World Ophthalmology Congress meeting. Dr. Obstbaum of New York University was not able to attend the meeting.

Dr. Rosen said that 45 million people are blind worldwide, with 135 million people reportedly having some form of vision disability. He added that world blindness is expected to increase at the rate of 2 million per year as the world's population gets older. Today, half of the world's blindness is related to unoperated cataracts.

"There is a significant need for increased information to deal with the cataract surgical backdrop as well as the increasing need for cataract surgery in an aging population," Dr. Rosen added.

With the World Health Organization's 20/20 initiative for the right to sight, the global initiative gives direction for blindness prevention that helps raise some indicators for disease control, human resource development, and provide infrastructure and technology. "Cataract surgery is an integral proponent of that initiative," Dr. Rosen said.

Delivery of care will be based on structure -- physical and organizational properties of a setting where quality eye care is provided. Dr. Rosen outlined the structural indicators, which include surgical environment, education and training for physicians, medical care and equipment, and anesthesia personnel.Process indicators include diagnosis, patient education, informed consent, and appropriate indicators for surgery. Outcome indicators include visual acuity, adverse events, glare and contrast sensitivity, visual rehabilitation, refractive stability, and patient satisfaction.

The goals for cataract surgery are to improve visual acuity, to improve functional vision, and to improve quality of life. "And, that is the real issue in all areas of blindness," Rosen added.

The global challenges for cataract surgical community are:

1) Deal with the backlog of patients with cataract blindness.2) Deal with the increasing number of patients with cataracts with an aging population.3) Standardize the approach to structure and process for managing cataract patients in global regions.4) Strengthen the efforts for adequate follow-up.5) Perform systematic data collection.6) Recognize that outcomes data are essential to the formulation of standards and approaches to managing cataract patients.