Modern Aspects of Cataract Surgery from the Standpoint of the Medical and Social Health Model. Review

Abstract

Purpose. Analysis of modern aspects of cataract surgery from the standpoint of the medical and social model of health.Methods. The analysis of literary data was performed in the RSCI and PubMed databases using the following keywords: “Medical model of health”, “Medical and social model of health”, “Phacoemulsification of cataracts” (PCE), “Quality of life” (QOL), “Calculation of intraocular lenses” (IOL), “Visually intense work”, “Ophthalmo-ergonomics”. The duration of the main retrospective analysis was 8 years (2017–2023) with citation (if necessary) of individual earlier sources.Results. Based on the analysis, the following main modern aspects of cataract surgery were identified from the standpoint of the medical and social model of health: QOL study; assessment of ophthalmo-ergonomic indicators; medical and psychological aspects (correction of postoperative pain syndrome and dry eye syndrome, neuroadaptation after implantation, primarily trifocal IOLs, patient anxiety level).Conclusion. Currently, the PCE procedure is almost completely optimized from a technical point of view. In this regard, consideration of the PCE effectiveness from the standpoint of the medical and social model of health seems relevant, since the main task of this model is the complete integration of an individual into society. The basic indicator reflecting the clinical effectiveness of PCE from the standpoint of the medical and social model of health is QOL. In this direction, the practical application of the «FEC-22» QOL assessment technique will ensure an increase in the level of clinical diagnostic research in cataract surgery when solving a number of urgent problems — comparative evaluation of IOLs, study of the effectiveness of postoperative rehabilitation methods for patients, selection of the optimal formula for calculating IOLs. In addition, from the standpoint of the medical and social model of health, further improvement of the ophthalmo-ergonomic indicators of the visual system and medical and psychological aspects associated with the patient is advisable. Ultimately, the development of a comprehensive system of measures to improve the clinical and diagnostic effectiveness of phacoemulsification based on the medical and social model of health will improve the level of ophthalmological care and prolong the professional longevity of patients (especially those with visual impairment) with cataracts.