San Francisco—Three programs in different geographic areas of the world serve as models of success in addressing cataract, the top cause of blindness globally, said David F. Chang, MD, who delivered the Binkhorst Lecture during the opening session.

The Aravind Eye Care System in southern India, the Tilganga Eye Centre in Kathmandu, Nepal, and Project Vision in China have made an impact by offering fast, low-tech, high-volume cataract surgery in ways that maximize the resources available in their areas, said Dr. Chang, clinical professor of ophthalmology at the University of California, San Francisco.

Patients undergoing phacoemulsification, who pay for their procedures, subsidize the care for the others, who receive manual small-incision cataract surgery (M-SICS). Most importantly, he said, the procedures are affordable, and research has shown that the complication rates are low and that M-SICS is effective at restoring functional vision in these populations.

"When you consider the reduction in life expectancy and the loss of productivity by the blind and those who care for them, there are very few medical interventions that can match cataract surgery in terms of cost effectiveness and its impact on human suffering," Dr. Chang said.

He thanked the leaders of these organizations "for their continually reminding me that, despite the fact that our own society, based on declining reimbursement, seems to value what we do less and less . . . good cataract surgeons remain one of the most precious and valuable assets for any society."