Cataract surgery in outreach camps gave worse vision than fixed facilities across 61 countries; retinal detachment after anti-VEGF is about 1 in 8,700 injections

The edition in brief

Across 168 population-based Rapid Assessment of Avoidable Blindness surveys in 61 countries (41,881 eyes operated between 2000 and 2020), cataract surgery in outreach camps was less likely to give presenting acuity of 6/18 or better than surgery in fixed facilities (60.6% vs 66.6%; OR 0.59, 95% CI 0.50 to 0.70); private hospitals did better than government ones (OR 1.56), and the gaps did not narrow over time. A meta-analysis of 787,849 anti-VEGF injections put rhegmatogenous retinal detachment at 0.012% per injection (about 1 in 8,675) and 0.08% per eye. In the BRAVE trial of 255 patients with branch retinal vein occlusion macular oedema, conbercept gained 16.9 letters at six months against 8.9 with deferred treatment. In the GALE extension, eyes given pegcetacoplan from the start preserved about three times more retina over 48 months than eyes started two years later. In 995 Chinese children, HOTV gave fewer unnecessary preschool referrals than tumbling E (18.6% vs 31.2%) with better specificity. The practical message: audit visual outcomes wherever cataract surgery happens, especially in camps, and quote a per-eye detachment risk when consenting for long-term injections.