Educating doctors, staff, patients regarding phaco is key for combating cataract blindness

Emanuel S. Rosen, FRCOphth, said without public pressure, the U.K. would still face a cataract surgeon shortage.

SAO PAULO, Brazil — With the incidence of global cataract blindness on the rise, speakers here emphasized that surgeon and staff training in phacoemulsification, as well as patient education, may be important factors in reducing the backlog of blindness.

Abhay Vasavada, MD, FRCS, said the ideal approach for implementing advanced cataract surgery in developing parts of the world is to teach phaco techniques in those countries.

“Phaco is a safer surgery, with superior clinical outcomes [than manual small-incision surgery or extracapsular cataract extraction],” Dr. Vasavada said. “It is important to accept this to achieve sustainable, quality eye care.”

Dr. Vasavada said that, thanks to aid from nongovernmental organizations, local governments and the ophthalmic industry, cost is not the primary impediment to lowering the incidence of cataract blindness.

“The real issue is training,” Dr. Vasavada said. “What we need are more paramedics. We need to train more paramedics.”

Inadequate training in phaco in medical schools is also common, he said.

Yehia Salah Mostafa, MD, agreed that phaco is the best surgical method to teach to surgeons in developing countries because it is faster than other options and a “perfect fit” for the situation.

“We really need to transfer knowledge to best serve our patients,” Dr. Mostafa said. “Training doctors is more important than just doing surgery.”

Looking at the global cataract blindness problem from the standpoint of supply and demand, Emanuel S. Rosen, FRCOphth, said in the end “it is a political problem.”

Mr. Rosen said that, in the United Kingdom, after the general public was educated about cataract surgery and its benefits, the public put pressure on the government to increase the number of cataract surgeons and surgeries it would finance.

In many developing countries, he said, the biggest problem is the ratio of ophthalmologists to general population. As an example, Mr. Rosen pointed out that there are as many ophthalmologists in the city of San Francisco as there are in all of Africa.