Cataract Care Research Articles

Assessment of Large Language Models in Cataract Care Information Provision: A Quantitative Comparison.

Cataracts are a significant cause of blindness. While individuals frequently turn to the Internet for medical advice, distinguishing reliable information can be challenging. Large language models (LLMs) have attracted attention for generating accurate, human-like responses that may be used for medical consultation. However, a comprehensive assessment of LLMs' accuracy within specific medical domains is still lacking. We compiled 46 commonly inquired questions related to cataract care, categorized into six domains. Each question was presented to the LLMs, and three consultant-level ophthalmologists independently assessed the accuracy of their responses on a three-point scale (poor, borderline, good) and their comprehensiveness on a five-point scale. A majority consensus approach established the final rating for each response. Responses rated as 'Poor' were prompted for self-correction and reassessed. For accuracy, ChatGPT-4o and Google Bard both achieved average sum scores of 8.7 (out of 9), followed by ChatGPT-3.5, Bing Chat, Llama 2, and Wenxin Yiyan. In consensus-based ratings, ChatGPT-4o outperformed Google Bard in the 'Good' rating. For completeness, ChatGPT-4o had the highest average sum score of 13.22 (out of 15), followed by Google Bard, ChatGPT-3.5, Llama 2, Bing Chat, and Wenxin Yiyan. Detailed performance data reveal nuanced differences in model capabilities. In the 'Prevention' domain, apart from Wenxin Yiyan, all other models were rated as 'Good'. All models showed improvement in self-correction. Bard and Bing improved 1/1 from 'Poor' to better, Llama improved 3/4, and Wenxin Yiyan improved 4/5. Our findings emphasize the potential of LLMs, particularly ChatGPT-4o, to deliver accurate and comprehensive responses to cataract-related queries, especially in prevention, indicating potential for medical consultation. Continuous efforts to enhance LLMs' accuracy through ongoing strategies and evaluations are essential.

A survey exploring ophthalmologists' attitudes and beliefs in performing immediate sequential bilateral cataract surgery in Singapore.

To evaluate current practice patterns of Immediate Sequential Bilateral Cataract Surgery (ISBCS) by ophthalmologists in Singapore and assess their attitudes towards performing ISBCS in future cataract care. An anonymised electronic survey, modified to local context from a similar study conducted in the United Kingdom, was distributed to members of the College of Ophthalmologists, Academy of Medicine, Singapore, from 20 June to 1 September 2023. An initial screening question on prior experience with ISBCS directed the rest of the survey. Questions explored ophthalmologists' current ISBCS practice patterns and the importance of factors affecting their willingness to perform ISBCS. Results were descriptively analysed. Results collated 2 months upon survey dissemination saw a total of 58 respondents from 235 eligible members (24.7% response rate). Of these, 16 (27.6%) were currently performing ISBCS, 37 (63.8%) had never performed, and 5 (8.6%) had stopped performing. In considering ISBCS, patient convenience (n = 11, 68.8%) and reduced hospital visits (n = 8, 50.0%) were the most important factors nominated. The most important barriers to performing ISBCS were medico-legal issues (n = 31, 83.8%) and risk of endophthalmitis (n = 27, 73.0%), followed by perceived lack of evidence for its effectiveness (n = 19, 51.4%). This is one of the first studies evaluating ophthalmologists' sentiments towards performing ISBCS in an Asian country. It highlights some of the most pertinent barriers and concerns that ophthalmologists face in performing and offering ISBCS. This study provides a better understanding of the potential role and prospects of ISBCS in future cataract care in Singapore.

Web-based telemonitoring of visual function and self-reported postoperative outcomes in cataract care: international multicenter randomized controlled trial.

To compare web-based, self-administered follow-up after cataract surgery to conventional face-to-face follow-up. Eye clinics in the Netherlands, Austria, and Germany. Randomized controlled trial with an embedded method comparison study (ClinicalTrials.gov: NCT04809402). Routine patients with cataract were randomized into 2 groups: The telemonitoring group undertook web-based vision self-assessments and questionnaires from home, while the usual care group received conventional care. All participants had a 4- to 6-week postoperative clinic visit for safety and validation purposes. Outcomes included, the web test's accuracy for assessing postoperative visual acuity (VA) and refractive error, adverse event rates, and patient-reported outcome measurements (PROMs). 94 participants (188 eyes) were enrolled. Web-based uncorrected distance VA testing demonstrated a negligible mean difference (-0.03 ± 0.14 logMAR) when compared with conventional Early Treatment Diabetic Retinopathy Study chart testing, with 95% limits of agreement ranging from -0.30 to 0.24 logMAR. The web-based refraction assessment overestimated the postoperative refractive error (mean difference in spherical equivalent 0.15 ± 0.67 diopters), resulting in a poorer corrected distance VA compared with subjective refraction (mean 0.1 vs -0.1 logMAR). Rates of adverse events and unscheduled consultations were minimal across both groups. Preoperative and postoperative PROM questionnaires had a 100% response rate. Visual functioning (Catquest-9SF and National Eye Institute Visual Function Questionnaire-25) improved postoperatively (mean improvement -0.80 and 16.70, respectively) and did not significantly differ between the 2 groups. The patients with cataract in this study effectively provided postoperative outcome data using a web interface. Both conventional and web-based follow-ups yielded similar PROMs and adverse event rates. Future developments should reduce the variability in the web-based VA test and yield representative refraction outcomes.

Ophthalmologists’ Perspective on Barriers to Cataract Surgery and Surgical Productivity in Ethiopia, Ghana, and Zambia: A Descriptive, Mixed-Methods Survey

ABSTRACT Purpose While progress was made towards the Vision 2020: The Right to Sight goals, Ethiopia, Ghana, and Zambia fell short of the recommended cataract surgical rate (CSR) on a national level. Post-operative cataract surgical outcomes are also lower compared to other regions. This study aimed to describe perceived barriers to cataract surgical uptake, factors related to surgeon surgical productivity, and surgical offerings in each of these countries. Methods An online survey was sent to ophthalmologists practicing in Ethiopia, Ghana, and Zambia. Responses were collected between June 25, 2021 and January 30, 2022. Results Responses were received from 122 ophthalmologists from Ethiopia, Ghana, and Zambia. The estimated participation rate was 47% (122/257). Distance to cataract surgical centres, lack of surgical centres, and lack of surgical equipment were among the top 10 most agreed upon barriers by respondents within each country. Many respondents reported that current financial reimbursement does not incentivise maximum productivity in themselves (56%, 68/122) or their staff (61%, 74/122). Surgeons proposed several ways to improve productivity incentives. Private practice was perceived to have the best reimbursement incentives (77%, 94/122), whereas government hospitals were least agreed upon (4%, 5/122). Discrepancies in timely post-operative refraction and eyeglasses disbursement were reported. Conclusions Overcoming the identified barriers, improving surgeon productivity, and addressing identified deficits in cataract care will likely reduce the backlog of cataract blindness while ensuring increasingly improved patient outcomes.

Feasibility of an artificial intelligence phone call for postoperative care following cataract surgery in a diverse population: two phase prospective study protocol

IntroductionArtificial intelligence (AI) development has led to improvements in many areas of medicine. Canada has workforce pressures in delivering cataract care. A potential solution is using AI technology that can...

Clinical Performance of New Enhanced Monofocal Intraocular Lenses: Comparison of Hydrophobic C-loop and Hydrophilic Plate-Haptic Platform.

Enhanced monofocal intraocular lenses (IOLs) represent a new type of lens, which should lead to a very good distance vision similar to monofocal IOLs and an improved intermediate vision without increasing the risk for photic phenomena. The aim of this clinical observation/registry study was to directly compare two different IOL platforms (hydrophilic acrylic L-333 (groupA) vs hydrophobic acrylic AN6Q (groupB)) with the same enhanced monofocal optic principle but different material and haptic design in clinical routine. A total of 102 cataract cases (51:51) were included in the study. Groups A and B were similar regarding demographics, age (71.6 ± 9years for L-333 and 73.6 ± 8years for AN6Q) and their calculated IOL power (20.9 ± 2.0D for L-333 and 21.5 ± 3.4D for AN6Q). Spherical equivalent (SE), (un)corrected distance, intermediate visual acuity, the surgeons' experience and patient feedback were assessed postoperatively. SE improved significantly in the AN6Q group, while the L-333 group showed a slightly smaller standard deviation postoperatively. In groupA the uncorrected distance visual acuity (UDVA) improved from pre-op (0.43 ± 0.16logMAR) to 1month post-op (0.06 ± 0.04logMAR) significantly and in groupB from pre-op (0.54 ± 0.19logMAR) to (0.05 ± 0.06logMAR) postoperatively. Both groups showed excellent outcomes for distance without negative side effects. On testing uncorrected intermediate vision (80cm) with Radner charts, 80% reached line5 (0.0logRAD) with fewer than one mistake and 10% reached line4 (- 0.1logRAD) in groupA; 74% reached line5 with fewer than one mistake and 4% reached line4 in groupB. Both IOL models (groupsA and B) provided satisfying results regarding implantation behaviour, refractive error, visual acuity and overall patient satisfaction. The haptic design might influence the outcome of refractive error. Long-term follow-up data should be considered in multicentre studies to further characterize both platforms and to optimize IOL power calculation (constants, surgeon factor). It was shown that the enhanced monofocal optic can provide good visual acuity for far distance and improve intermediate distance. This type of new monofocal optic design, which however must be strictly separated from typical refractive/diffractive multifocal, presbyopia-correcting lenses, could be a good option in standard cataract care.

Safety, effectiveness, and cost-effectiveness of immediate versus delayed sequential bilateral cataract surgery in the Netherlands (BICAT-NL study): a multicentre, non-inferiority, randomised controlled trial

In an ageing population, efficiency improvements are required to assure future accessibility of cataract care. We aim to address remaining knowledge gaps by evaluating the safety, effectiveness, and cost-effectiveness of immediate sequential bilateral cataract surgery (ISBCS) versus delayed sequential bilateral cataract surgery (DSBCS). We hypothesised that ISBCS is non-inferior to DSBCS, regarding safety and effectiveness, and being superior in cost-effectiveness. We did a multicentre, non-inferiority, randomised controlled trial, which included participants from ten Dutch hospitals. Eligible participants were 18 years or older, underwent expected uncomplicated surgery, and had no increased risk of endophthalmitis or refractive surprise. Participants were randomly assigned (1:1) to either the ISBCS (intervention) group or DSBCS (conventional procedure) group, using a web-based system stratified by centre and axial length. Participants and outcome assessors were not masked to the treatment groups because of the nature of the intervention. The primary outcome was the proportion of second eyes with a target refractive outcome of 1·0 dioptre (D) or less 4 weeks postoperatively, with a non-inferiority margin of -5% for ISBCS versus DSBCS. For the trial-based economic evaluation, the primary endpoint was the incremental societal costs per quality-adjusted life-year. All analyses were done by a modified intention-to-treat principle. Costs were calculated by multiplying volumes of resource use with unit cost prices and converted to 2020 Euros (€) and US$. This study was registered with ClinicalTrials.gov, number NCT03400124, and is now closed for recruitment. Between Sept 4, 2018, and July 10, 2020, a total of 865 patients were randomly assigned to either the ISBCS group (427 [49%] patients; 854 eyes) or DSBCS group (438 [51%] patients; 876 eyes). In the modified intention-to-treat analysis, the proportion of second eyes with a target refraction of 1·0 D or less was 97% (404 of 417 patients) in the ISBCS group versus 98% (407 of 417) in the DSBCS group. The percentage difference was -1% (90% CI -3 to 1; p=0·526), thereby establishing non-inferiority for ISBCS compared with DSBCS. Endophthalmitis was not observed or reported in either group. Adverse events were comparable between groups, with only a significant difference in disturbing anisometropia (p=0·0001). Societal costs were €403 (US$507) lower with ISBCS than with DSBCS. The cost-effectiveness probability of ISBCS versus DSBCS was 100% across the willingness-to-pay range of €2500-80 000 (US$3145-100 629) per quality-adjusted life-year. Our results showed non-inferiority of ISBCS versus DSBCS regarding effectiveness outcomes, comparable safety, and superior cost-effectiveness of ISBCS. National cost savings could amount to €27·4 million (US$34·5 million) annually, advocating for ISBCS if strict inclusion criteria are applied. Research grant from The Netherlands Organization for Health Research and Development (ZonMw) and Dutch Ophthalmological Society.

Nationwide Rapid Assessment of Avoidable Blindness (RAAB) in Armenia

ABSTRACT Purpose This study aimed to estimate the prevalence and main causes of blindness and visual impairment in population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology. Methods The study team randomly selected 50 clusters (each consisting of 50 people) from all 11 regions of Armenia. Data on participants’ demographics, presenting visual acuity, pinhole visual acuity, principal cause of presenting visual acuity, spectacle coverage, uncorrected refractive error (URE), and presbyopia were collected using the RAAB survey form. Four teams of trained eye care professionals completed data collection in 2019. Results Overall, 2,258 people of 50 years and older participated in the study. The age- and gender- adjusted prevalence of bilateral blindness, severe and moderate visual impairment were 1.5% (95% CI: 1.0–2.1), 1.6% (95% CI: 1.0–2.2) and 6.6% (95% CI: 5.5–7.7), respectively. The main causes of blindness were cataract (43.9%) and glaucoma (17.1%). About 54.6% and 35.3% of participants had URE and uncorrected presbyopia, respectively. The prevalence of bilateral blindness and functional low vision increased with age and was the highest in participants 80 years and older. Conclusion The rate of bilateral blindness was comparable with findings from countries that share similar background and confirmed that untreated cataract was the main cause of blindness. Given that cataract blindness is avoidable, strategies should be developed aiming to further increase the volume and quality of cataract care in Armenia.

Remote follow-up after cataract surgery (CORE-RCT): study protocol of a randomized controlled trial

BackgroundCataract surgery has become one of the most performed surgical procedures worldwide. Postoperative management consists of routine clinical examinations to assess post-operative visual function and detect possible adverse events. Due to the low incidence of complications, the majority of clinic visits after cataract surgery are uneventful. Nonetheless, valuable time and hospital resources are consumed. We hypothesize that remote post-operative follow-up involving teleconsultations and self-assessments of visual function and health status, could be a valid alternative to face-to-face clinical examinations in selected patient groups. The practice of remote follow-up after cataract surgery has not yet been evaluated. The aim of this study is to investigate the validity, safety and cost-effectiveness of remote cataract surgery follow-up, and to report on the patients’ experiences with remotely self-assessing visual function.MethodsThis study is a multicenter, open-label, randomized controlled trial. Patients planned for cataract surgery on both eyes, without ocular comorbidities, are eligible for participation. Participants will be allocated (1:1) into one of the two study groups: ‘telemonitoring’ or ‘usual care’. Participants in the ‘telemonitoring’ group will perform in-home assessments after cataract surgery (remote web-based eye exams and digital questionnaires on their own devices). Participants in the ‘usual care’ group will have regular post-operative consultations, according to the study site’s regular practice. Outcome measures include accuracy of the web-based eye exam for assessing visual acuity and refraction, patient-reported outcome measures (visual function and quality of life), adverse events, and cost aspects.DiscussionInvestigating remote follow-up after cataract surgery fits the current trends of digitization of health care. We believe that remote self-care can be a promising avenue to comply with the increasing demands of cataract care. This randomized controlled trial provides scientific evidence on this unmet need and delivers the desired insights on (cost)effectiveness of remote follow-up after cataract surgery.Trial registrationClinicalTrials.gov: NCT04809402. Date of registration: March 22, 2021.

Chat Generative Pretrained Transformer to optimize accessibility for cataract surgery postoperative management

Abstract Cataract surgery is one of the most common surgeries (over 3 million cases) in the United States per year. Consequently, there are multiple diverse and unique postoperative questions in the postoperative course following cataract extraction. To provide rapid and accessible guidance, large language models may help optimize this area in cataract surgery. Chat Generative Pretrained Transformer (GPT) is a complex conversational artificial intelligence model built by OpenAI and trained using an extensive collection of textual data sourced from the internet. The utilization of ChatGPT has a significant potential for diverse applications within various academic disciplines. In the field of medicine, it has the potential to aid health-care professionals, researchers, and patients through a variety of ways. We describe the use of ChatGPT to respond to common postoperative questions associated with cataract extraction. Although further research is required before more widespread acceptance and clinical implementation, we believe that GPT-4 has the potential to improve cataract and refractive postoperative care by providing immediate and accurate responses to patient queries.

Effectiveness of educational intervention among nursing staff in improving post-operative cataract care in a tertiary care centre

Effectiveness of educational intervention among nursing staff in improving post-operative cataract care in a tertiary care centre

The true cost of hidden waiting times for cataract surgery in Australia.

Cataract surgery is a safe, effective and common elective procedure in Australia but access is inequitable. True waiting times for cataract care are undisclosed or inconsistently reported by governments. Estimates of true waiting times range from 4 to 30 months and have been extended during the coronavirus disease 2019 (COVID-19) pandemic. Comparative analysis revealed that reducing waiting periods from 12 to 3 months would result in estimated public health system cost savings of $6.6 million by preventing 50 679 falls. Investment in public cataract services to address current unmet needs would prevent avoidable vision impairment and associated negative consequences.

PECARE: Parental Feedback to Improve Congenital Cataract Care in Sweden.

To analyze non-directed parental feedback to health care providers responsible for pediatric cataract care in Sweden. A directed content analysis was used to analyze data consisting of text representing free comments provided by 40 parents. A deductive approach was employed by applying the model of balancing the child's inability and ability, which includes the categories mastering, collaborating, facilitating, and adapting. Parents lacked piloting and self-management support. They experienced an absence of partnership with the health care team and not being taken seriously. They also felt abandoned by health care, resulting in emotional distress. Parents highlighted the impact of their social network and the challenges involved in accepting and adapting to the changes in everyday life. This study emphasizes the consequences of the lack of a caring partnership with health care professionals. Because parents act as mediators of care to the child with congenital cataract, persistence on the part of parents and a family-centered approach are essential for the child's visual development. [J Pediatr Ophthalmol Strabismus. 2023;60(4):298-294.].

Do patients and other stakeholders value health service quality equally? A prospect theory based choice experiment in cataract care

ObjectivesThis study aims to compare the valuation of health service quality by patients and other stakeholders through a case study in cataract care. MethodsThe valuation of health service quality by Dutch patients, ophthalmologists and healthcare purchasers involved in cataract care are elicited by a prospect theory-based measurement task. Respondents stated preferences for probabilities and scores for the clinical indicator Complication (posterior capsular rupture with vitreous loss) and the patient-reported experience measure Information Provisioning (the ophthalmologist provides sufficient information about risks of cataract surgery to the patient). Our subject pool (n = 256) consisted of 90 ophthalmologists, 125 cataract patients, and 41 healthcare purchasers employed by health insurance companies. ResultsFollowing prospect theory, respondents were loss averse, and risk averse for gains. However, utilities differed from prospect theory, especially the concave utility for losses. Patients were significantly more loss averse than the other respondents, more subject to a pessimistic view on losses, and had significantly more concave utility for losses, especially for the clinical quality indicator Complications. For each of the stakeholders, the results differed significantly between the two essentially different quality indicators. ConclusionsThe heterogeneous valuations of patients and other stakeholders invalidate commonly applied cataract care quality assessment frameworks. Incorporating loss aversion, pessimism and concave utility for losses can remedy existing shortcomings. The valuation differences between patients and other stakeholders emphasize the need for communication and shared decision making in patient-centered treatment, purchasing and policy.

Clinical Practice of Cataract Special Care Standards in Nonophthalmic Wards

Cataract is a lens metabolism disease, which is caused by various factors, and leads to metamorphic lens proteins turbidity. Cataract commonly occurs in elderly patients, and majority of these patients have clinical manifestations of blurred vision and other symptoms. In this study, we explored the clinical practice and observations of cataract care criteria in nonophthalmic wards. To realize this, a total of one hundred and twenty (120) cataract patients, admitted to the East Department of Ophthalmology, Shanghai Sixth People's Hospital, particularly from April 2019-2020, were divided into the control and observation groups, where 60 cases were added to each group. The control group received routine nursing, and observation group was treated with cataract care criteria based on the control group. The complication rate, health cognition, and patient's satisfaction were compared with existing approaches. The incidence of corneal edema, anterior chamber hemorrhage, endophthalmitis, and incision infection, specifically in the observation group, was lower than that in the control group (P < 0.05). Likewise, the number of hospitalization days and expenses, specifically in the observation group, were lower than those in the control group (P < 0.05). Health knowledge and satisfaction scores of the observation group were higher than the control group (P < 0.05). Active service, service attitude, psychological support, caring patients, and health education dissatisfaction rate of the observation group were lower than the control group (P < 0.05). Finally, the standard of cataract care in nonophthalmic wards reduces the incidence of complications, improve health awareness of patients, and help to improve satisfaction of patients with nurses. Furthermore, it is worthy of promotion and application particularly in traditional hospitals.

A Cost Comparison of Cataract Surgeries in Three Countries — United States, India, and Nepal

Summary U.S.-based cataract surgeries are costly compared with those performed in high-quality Indian and Nepalese eye centers. The authors used time-driven activity-based costing to evaluate phacoemulsification surgery across four sites: an academic hospital outpatient department (HOPD) and an ambulatory surgery center (ASC), both in the United States, Aravind Eye Hospital in Pondicherry, India (AEH-P), and Tilganga Institute of Ophthalmology (TIO) in Kathmandu, Nepal. Indexing HOPD to $100 and correcting for purchasing power parity, the costs of cataract care were $42.00 at ASC, $21.50 at AEH-P, and $16.10 at TIO. Lower cost at the two South Asian sites can be attributed in part to faster patient throughput, avoidance of intravenous anesthesia, increased use of mid-level staff, and more frequent reuse of supplies. Significant savings may be achieved in the United States through adoption of these practices, but it may require new incentives within the nation’s health system.

Multi-stakeholder perspectives in defining health services quality indicators and dimensions: a concept mapping based comparison for cataract care between Singapore and The Netherlands

ObjectiveThis study aims to advance understanding of globally valid versus country-specific quality dimensions and indicators, as perceived by relevant stakeholders. It specifically addresses patient-level indicators for cataract surgery.DesignA mixed-methods case...

Community optometrist-led post-operative cataract care: how many patients re-present to the hospital ophthalmic department?

BackgroundCataract surgery represents a significant workload for ophthalmologists in Ireland. Post-operative shared care with community optometrists can reduce the need for hospital follow-up appointments.AimsEight years after the introduction of a shared-care pathway, we wished to quantify the proportion of patients discharged to the community for post-operative follow-up, and the number that re-present to the hospital due to cataract-related issues.MethodsWe collected data on all patients who underwent cataract surgery in our centre over a three month period. Electronic patient records were used to establish whether the patient was discharged on the day of surgery, and whether they re-attended the department post-operatively. Post-operative complications were recorded.Results394 cataract procedures were carried out over the three months. 369 patients were discharged to an optometrist for their post-operative care. Of those, 38 were re-referred or re-presented to the hospital ophthalmic service. 21 of these had a post-operative complication. Complications included seven cases of post-operative uveitis, 5 patients with cystoid macular oedema, one retinal detachment and one retained lens fragment.ConclusionsCommunity optometrist-led post-operative care for uncomplicated patients is an effective way of reducing the workload associated with cataract surgery. Re-referral pathways must be in place to facilitate timely management of post-operative complications.

Barriers related to the provision of cataract surgery and care in Limpopo province, South Africa: Professional ophthalmic service providers’ perspective

BackgroundCataract has been reported to be the leading single cause of visual impairment and blindness. However, uptake of cataract services is very low in rural areas though these services are available for free. This study, therefore, sought to explore barriers related to the low uptake of these services through engaging health service providers. MethodsThis study used a qualitative design to explore barriers related to the uptake of cataract surgery and care from professional nurses’ perspective in Vhembe District of Limpopo province, South Africa. The target population comprised of 20 ophthalmic service providers. Of these 20 in Limpopo Province, 15 were general nurses involved in eye health service provision, 3 registered ophthalmic nurses and 2 registered eye specialists. Three Focus Group Discussions were held with 8, 6 and 6 participants respectively. Data was collected through the use of a digital tape recorder, transcribed and then thematically analyzed. ResultsThe majority of the respondents were aged between 56 and 60 years and females constituted 80% of the respondents. In terms of experience in working in the field of ophthalmology, most of the respondents had between 1 and 10 years of experience. Reported barriers related to the provision of cataract services by patients were: Lack of provision of comprehensive awareness programs; Failure to tailor-make cataract programs that overcome cultural myths; Unavailability of cataract services at the grass-root level; Shortage of ophthalmologist and supportive ophthalmic health professionals; and inadequate cataract facilities and resources. ConclusionThere is a need for the development of comprehensive awareness campaigns and the integration of traditional health systems and the modern system to overcome myths associated with cataracts. There is a need for investment in the ophthalmic services and ensure that the service is decentralized to health facilities in the communities so as to increase coverage. More health service providers are to be trained to ensure that they are able to provide this service at the grass-root level. This would, in turn, reduce the waiting times and ensure efficient and effective ophthalmic services.

The effects of focused resolution model on anxiety level in patients undergoing cataract surgery

Objective To explore the effect of focused solution on anxiety level in patients undergoing cataract surgery. Methods From November 2016 to April 2017, 100 cases of cataract surgery patients in the day ward of Henan Provincial People's Hospital were selected and divided into the intervention group and the control group according to the table of random numbers, 50 cases of each group.The control group received routine cataract care, and the intervention group, on the basis of the control group, applied focused solution mode to provide psychological guidance to the patients 1 day before the operation, 1 morning after the operation and 1 week after the operation.Anxiety levels in the two groups were compared at different time periods. Results There was no significant difference in preoperative anxiety between the two groups(P>0.05). In the morning of operation day and 1 week after operation, the difference in anxiety value between the two groups was statistically significant(P<0.05). Conclusions The focused resolution model can help ease anxiety levels in patients undergoing cataract surgery. Key words: Cataract; Anxiety; Focused resolution model