ABSTRACT
Cataract surgery is a highly cost-effective treatment, but the surgical intervention rate in New Zealand ranks poorly compared with other high-income countries. The combination of a growing and ageing population, lost operating time due to the COVID-19 pandemic, and geographical disparities, is driving up an unmet demand for cataract surgery. We present several evidence-based strategies with overlapping benefits in access, equity, efficiency and sustainability. Key strategies include that Health New Zealand mandate a national prioritisation threshold for surgical access, and that PHARMAC leverage cheaper access to surgical supplies using nationally agreed equipment standards, establishing high-throughput cataract units, offering same day bilateral cataract surgery when appropriate, and rationalising post-operative care.