Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 28;14(9):3037.
doi: 10.3390/jcm14093037.

Comparison of Cost-Utility, Visual Acuity, and Humanistic Outcomes of Cataract Surgery Performed in the United States Versus International Outreach Campaigns

Lauren E Chen  1 , Ryka Vahidi  2 , Anna Kesler-Diaz  3 , Sameh Mosaed  1
Affiliations

Comparison of Cost-Utility, Visual Acuity, and Humanistic Outcomes of Cataract Surgery Performed in the United States Versus International Outreach Campaigns

Lauren E Chen et al. J Clin Med. .

Abstract

Background: This study compares the cost-utility, visual acuity, and humanistic outcomes of phacoemulsification surgery performed during international outreach campaigns to outcomes in the U.S. Objective: Humanitarian organizations frequently perform cataract surgeries in underserved regions, yet the outcomes of phacoemulsification in these settings remain unexplored. This study aims to compare the visual acuity outcomes, quality-of-life outcomes, and cost of phacoemulsification surgery during international outreach campaigns with those in the U.S. Methods: This retrospective review analyzed 344 cases from Women for World Health (W4WH) missions and 305 consecutive cases from the academic practice of the lead surgeon of W4WH in the US. The pre-operative (pre-op) visual acuity, post-operative (post-op) visual acuity at day 1, and best-corrected visual acuity (BCVA) at post-op month 1 were compared to baseline. The change in visual acuity was compared between the two groups. Complication rates, cost per case, and quality-of-life measures were evaluated for the mission group compared to cataract surgery outcomes in the developed world. Results: The mission cohort had worse baseline visual acuity than the U.S. cohort (1.36 logMAR vs. 0.50 logMAR, p < 0.0001) and showed greater mean improvement (1.24 logMAR vs. 0.35 logMAR, p < 0.0001). Both cohorts achieved similar BCVA at post-op month 1 (0.13 logMAR). The cost for the mission group was USD 276 per surgery. A total of 93.94% of patients in the mission group achieved a BCVA of 20/40 or better, which is comparable to the U.S. outcomes. Conclusions: The dramatic impact, immediacy, and enduring effect of cataract surgery using phacoemusification on quality of life, mental health, and economic return on investment make it the ideal procedure for humanitarian settings. Considering all of the available metrics, our data support the continued expansion of humanitarian efforts by cataract surgery organizations worldwide.

Keywords: international outreach; phacoemulsification; quality of life.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Visual-acuity outcomes for the mission and U.S. groups.
Figure 2
Figure 2
Quality-of-life outcomes for the mission and U.S. groups.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. GBD 2019 Blindness. Vision Impairment Collaborators. Vision Loss Expert Group of the Global Burden of Disease Study Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The Right to Sight: An analysis for the Global Burden of Disease Study. Lancet Glob. Health. 2021;9:e144–e160. doi: 10.1016/S2214-109X(20)30489-7. - DOI - PMC - PubMed
    1. Velez G., Fortenbach C.R., Oetting T.A. Global Causes of Preventable Blindness and Vision Impairment. EyeRounds.org. Feb 22, 2022. [(accessed on 10 March 2025)]. Available online: https://eyerounds.org/tutorials/global-blindness/index.htm.
    1. Wang W., Yan W., Fotis K., Prasad N.M., Lansingh V.C., Taylor H.R., Finger R.P., Facciolo D., He M. Cataract Surgical Rate and Socioeconomics: A Global Study. Investig. Ophthalmol. Vis. Sci. 2016;57:5872–5881. doi: 10.1167/iovs.16-19894. - DOI - PubMed
    1. Hashemi H., Fayaz F., Hashemi A., Khabazkhoob M. Global prevalence of cataract surgery. Curr. Opin. Ophthalmol. 2024;36:10–17. doi: 10.1097/ICU.0000000000001092. - DOI - PubMed
    1. Yan W., Wang W., van Wijngaarden P., Mueller A., He M. Longitudinal changes in global cataract surgery rate inequality and associations with socioeconomic indices. Clin. Exp. Ophthalmol. 2018;47:453–460. doi: 10.1111/ceo.13430. - DOI - PubMed

LinkOut - more resources