Impact of Cataract Surgery on Income in Rural Southern China: The SUCCESS Randomized Controlled Trial.

Area of Science:

• Ophthalmology
• Public Health
• Health Economics

Background:

• Visual impairment due to cataracts disproportionately affects low-income populations globally.
• Limited evidence exists on the economic impact of cataract surgery on personal income.
• Cataract surgery is a common and effective treatment for visual impairment.

Purpose of the Study:

• To investigate the causal effect of cataract surgery on personal income in a rural Chinese population.
• To determine if restoring vision through surgery can alleviate poverty.

Main Methods:

• A randomized controlled trial (RCT) involving 292 participants aged 50 years and older in rural Guangdong, China.
• Participants had vision impairment (<6/19) due to cataracts and were randomized to receive surgery within 4 weeks or after 1 year.
• Demographic characteristics, income, and quality of life were assessed at baseline and end-line over a 1-year period.

Main Results:

• The intervention group, receiving surgery earlier, experienced a significantly greater mean 1-year income increase ($1119, 54.0% relative increase) compared to the control group ($-206).
• The between-group difference in income increase was $1325 (P < 0.001).
• Multivariable analysis confirmed that receiving cataract surgery was independently associated with a greater increase in income (β = 1143.2; P < 0.001).

Conclusions:

• Cataract surgery provides a substantial increase in personal income for individuals in rural China.
• The findings suggest that cataract surgery can be an effective strategy for poverty alleviation.
• The correlation between improved visual acuity and increased income supports the biological plausibility of these economic benefits.