title: Outcomes and projected impact on vision restoration of the China Million Cataract Surgeries Program.
abstract: OBJECTIVE
  The recently completed Chinese "Million Cataract Surgeries Program" (MCSP) is among the largest such campaigns ever, providing 1.05 million operations. We report MCSP outcomes for the first time, in Jiangxi, the province with the greatest program output.
  
  
  METHODS
  Ten county hospitals participating in MCSP were selected in Jiangxi (range of gross domestic product per capita US$743-2998). Each hospital sought to enroll 75 consecutive MCSP patients aged ≥ 50 years. Data recorded included type of cataract procedure, bilateral uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), and refractive error pre- and ≥ 50 days postoperatively.
  
  
  RESULTS
  Among 715 patients (mean age 72.3 ± 9.1 years, 55.5% female), preoperative UCVA was <3/60 (legally blind) bilaterally in 13.3% and unilaterally in the operated eye in 50.9%. No subjects had UCVA >6/18 preoperatively. Small incision cataract surgery was performed in 92.3% patients. Among 662 patients (92.6%) completing follow-up was ≥ 40 days after surgery, BCVA was ≥ 6/18 in 80.1%, UCVA was ≥ 6/18 in 57.1% and UCVA was <3/60 in 2.1%. Older age (p < 0.001), female sex (p = 0.04), worse refractive error (p = 0.02) and presence of intra- (p = 0.002) and postoperative surgical complications (p < 0.001), were independently associated with worse postoperative UCVA. Based on these results, the MCSP cured an estimated 124,950 cases (13.3% × [100-2.1%] × 1.05 million) of bilateral and 502,500 (50.9% × [100-2.1%] × 1.05 million) of unilateral blindness.
  
  
  CONCLUSIONS
  Due to relatively good outcomes and the large number of surgeries performed on blind persons, the sight-restoring impact of the MCSP was probably substantial.
authors.affiliation: Department of Preventive Ophthalmology and State Key Laboratory, Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , China .
authors.forename: Xixi
authors.initials: X
authors.lastname: Yan
authors.forename: Chunhong
authors.initials: C
authors.lastname: Guan
authors.forename: Andreas
authors.initials: A
authors.lastname: Mueller
authors.forename: Beatrice
authors.initials: B
authors.lastname: Iezzi
authors.forename: Mingguang
authors.initials: M
authors.lastname: He
authors.forename: Hui
authors.initials: H
authors.lastname: Liang
authors.forename: Mirjam
authors.initials: M
authors.lastname: Meltzer
authors.forename: Nathan G
authors.initials: NG
authors.lastname: Congdon
mesh_terms: D000368:Aged; D002386:Cataract / Q000453:epidemiology*; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D011446:Prospective Studies; D012424:Rural Population / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology