Table 1. Summary table of included studies.
| Reference (author, year) | Location, participants, and sample size | Study design | Primary outcome; context; conditions of surgery | Surgery uptake | Study quality |
|---|---|---|---|---|---|
| Liu et al., 2012 | China, Guandong. Patients 50+ years with cataract and PVA<6/18 recruited through screening in five rural hospitals; N = 212 intervention and N = 222 control. | Randomised Controlled Trial | Outcome: surgery in at least one eye 6 months or less after the screening Cost of surgery reimbursed by government insurance | 31.1% intervention and 34.2% controls | Low risk of bias |
| Xiu Juan Zhang et al., 2013 | China, Pucheng Shaanxi Province Patients 50+ years with operable cataract recruited through a screening programme across 24 towns; N = 541 identified and referred. N = 355 referred but did not take up referral, could be found and agreed to take part (73.8% (N = 262 women) | Prospective, randomized, intervention design. | Outcome: surgery within 3 months after the screening/ study recruitment A low-cost cataract surgery (240 RMB (~USD 38)) in the County Hospital (initial screening and group 1); free surgery in group 2; free surgery and reimbursement of transportation (after the surgery) in group 3; free surgery and free rides to and from the hospital in group 4. Reminders were sent in all groups 2 and 5 days after the referral. | 20.1% initial (pre-intervention) (109/541) Post-intervention: 14.4% Group 1 (13 /86). 27.8% Group 2 (25/86) 31.1% Group 3 (28 /90). 28% Group 4 (26/93) | Low risk of bias |
| Ackuaku-Dogbe, Yawson, & Biritwum, 2015 | Ghana. Rural and urban settings; Older adults 50+ years with self-reported diagnosed cataract recruited from the general population; N = 231 (124 female, 107 male). | A cross sectional survey of the nationally representative sample. | Outcome: self-reported surgery in the past five years. The context and conditions of surgeries is unknown. |
48.9% overall (113/231); 48.4% women (60/124) 49.5% men (53/107). | Medium risk of bias |
| Amritanand, Jasper, Paul, & Kuriakose, 2018 | Southern India Tamil Nadu Patients with operable cataract identified through an outreach programme (screening camps and clinics in primary and secondary facilities); N = 4682 and a subset of 196 bilaterally cataract blind patients who underwent surgery | A retrospective cohort study of cataract patients referred for surgery and a cross-sectional survey of bilaterally blind patients operated for cataract | Outcome: uptake of referrals over one year. Surgeries at a base hospital; patients were either referred or provided transport; surgeries performed at a subsidized rate or free of charge; patients also received free food at the hospital. | 76.4% uptake of referral (3577/4682) 67.9% uptake of surgery (3178/4682) | Medium risk of bias |
| Finger et al., 2011 | Southern India, Tamil Nadu Individuals aged 30+ years with cataract and corrected VA of <6 ⁄ 60 or those who were thought to benefit from surgery identified through outreach clinics following community mobilisation and door to door search of blind patients N = 1,045 in two districts (N = 797 and N = 248) | A retrospective study of a cohort of patients referred for cataract surgery | Outcome surgery 6 months or earlier after the referral. Five camps over 14 months in one district and eight camps over 6 months in another district. For those with a monthly household income < Rs. 1200 (approx. 25 US$;) surgery, inpatient stay, transport from and to hospital and eye drops post-surgery were provided free. | 91.7% overall uptake 94.6% in district with regular outreach 82.3% in district with irregular outreach | Medium risk of bias |
| Syed et al., 2013. | Kenya, Nakuru district, Bangladesh, Satkhira district; the Philippines, Antique district, and Negros Island. Patients aged 50+ years with BCVA <6/24 in the better eye due to cataract identified through a population-based survey and case detection in the community N = 147 in Kenya, N = 217 in Bangladesh and N = 238 in the Philippines. | A longitudinal survey with one year follow up | Outcome: attendance for surgery 12 months after the referral. In Kenya and Bangladesh, surgery was free and transport expenses were reimbursed for all cases; In the Philippines, costs were subsidized for those who could not afford the fee. All cases were visited up to four times to encourage them to attend for surgery |
58.6% in Kenya, 53.9% in Bangladesh 47.1% in the Philippines; | Medium risk of bias |
| Razafinimpanana, Nkumbe, Courtright, & Lewallen, 2012 | Madagascar, Sava Region. Individuals aged 16+ years with cataract and VA <6/60 identified by case finders in the community | A prospective cohort study of patients with cataract | Outcome: attending hospital appointment next day after the screening. Patients recruited over 9 months period. Surgeries at SALFA Eye Clinic with the price for surgery adjusted according to a patient’s ability to pay | 25.9% referral uptake (35/142) 24.6% surgery uptake (32/142) | High risk of bias |