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Background Cataract is the leading cause of blindness globally and a major driver of disability, stigma, and economic exclusion in low-resource settings. We assessed cataract surgery's broader impacts on functioning, stigma, and economic wellbeing in rural sub-Saharan Africa, where evidence remains limited. Methods We conducted a prospective cohort study among adults ≥18 years with operable cataracts in rural Mozambique who accepted surgery. Between June and December 2023, 927 patients received cataract surgery and were followed for 12 months. Outcomes included presenting visual acuity; self-reported daily functioning; vision-related quality of life; economic participation; food and income sufficiency; and internalised and community stigma. Descriptive statistics summarised changes over time. McNemar's test was used for binary outcomes and the Wilcoxon matched-pairs signed-rank test for continuous outcomes. Findings Among 927 participants (mean age 70.4 years, standard deviation 11.3; 48.5% female), difficulty seeing declined from 80.2% to 4.6%, and other difficulties from 58.6% to 14.4%. Reports of poor general health decreased from 22.7% to 5.0%. Median vision-related quality of life scores increased from 38.5 to 81.0. Participation in paid work increased from 9.4% to 18.9%, and own work from 35.4% to 76.1%. Food and income insufficiency declined substantially. Internalised stigma decreased from 54.0% to 3.0%, and community stigma from 37.1% to 2.4%. All changes were statistically significant (p < 0.001). Interpretation Cataract surgery was associated with marked improvements in vision, functioning, health, economic participation, and stigma, underscoring its value as both a clinical and socioeconomic intervention in underserved rural settings. Funding This study was funded by Sightsavers.
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Bechange et al. (2026) studied this question.