Talk:Cataract surgery/GA1

GA Review

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Reviewer: Oltrepier (talk · contribs) 14:10, 13 August 2023 (UTC)

Hello, thank you for nominating this article! I'm planning to start this review and get it over the line in the next few days. As a Medicine student, I'll do my best to help get the article in better shape: however, while I'm already familiar with navigating databases such as PubMed, NCBI and OMIM, I must note that I've made only a few edits on healthcare-related pages in here so far, and I'm keeping learning the basics of editing medical articles. That being said, I hope my contributions will still be helpful and correct enough. Oltrepier (talk) 14:10, 13 August 2023 (UTC)

Recommendations for improvement always welcome. Cheers, · · · Peter Southwood ^(talk): 15:33, 13 August 2023 (UTC)

One of the things that is not listed in the GA criteria specifically is whether the content is reasonably accessible to the people likely to read it. As a medical student, you should be a notch above the target audience, so if you find anything vague, or incomprehensible, it probably needs to be fixed. Just let me know. It has very recently been given a pretty thorough copy edit by a competent editor from WP:GOCE, so the language should be fine. Cheers, · · · Peter Southwood ^(talk): 16:35, 14 August 2023 (UTC)

As GA reviewer you are not actually expected to make the improvements yourself. The tradition is to tell the nominator what needs to be done, but sometimes it is less work to just make an uncontroversial edit yourself instead of explaining the issue. I am not fussy. If I don't like it, I will explain why. If it doesn't matter I will just leave it, and if it is a good change I will let you know too. · · · Peter Southwood ^(talk): 16:42, 14 August 2023 (UTC)

@Peter Southwood Perfectly fine, thank you for clarifying! I should be able to go through the entire article and give my verdict tomorrow. Oltrepier (talk) 19:53, 14 August 2023 (UTC)

GA review (see here for what the criteria are, and here for what they are not)
It is reasonably well written. a (prose, spelling, and grammar): b (MoS for lead, layout, word choice, fiction, and lists): It is factually accurate and verifiable. a (references): b (citations to reliable sources): c (OR): d (copyvio and plagiarism): It is broad in its coverage. a (major aspects): b (focused): It follows the neutral point of view policy. Fair representation without bias: It is stable. No edit wars, etc.: It is illustrated by images, where possible and appropriate. a (images are tagged and non-free images have fair use rationales): b (appropriate use with suitable captions):
Overall: Pass/Fail:
· · ·

• @Pbsouthwood: Well, it's safe to say that I didn't deliver on my original promise, so I wanted to apologize for it. Still, I've finally finished checking the article and the sources, and I'll comment on that right down below! I must address I've boldly done some more copy-editing myself throughout the whole page, in an attempt to simplify and improve several statements, so let me know what you think about it: you and Baffle gab1978 already did an excellent job at improving the article overall, though!

• Some comments and queries on your edits. They are interleaved to make it easier to find the context.
  • Many appear to be slight improvements in readability or represent a difference in style between you, Baffle gab1978 and myself. They might be technically out of scope for GA review, but I am fine with that.
  • You have added several redundant links, whereas Baffle gab1978 removed several redundant links. I am not fussy about redundant links, and consider them to often be useful to the reader. You have also added links to things which I had not thought necessary, but on reflection may be useful to some readers. So also no problem to me.
  • You changed text to the cataract is extracted through a cryoprobe (my empasis), which to me implies that a cryoprobe is hollow and large enough for a cataract to pass through. I am not conversant with the structural details, but I found this surprising and counterintuitive. Is this what you intended to convey, and do you have a source to support it? · · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
    • I found some information on cryoprobes. It is definitely not a hollow tube through which a cataract can be drawn, the tip is small and the cataract is frozen to the end. I have reverted this change.· · · Peter Southwood ^(talk): 09:22, 21 August 2023 (UTC)
      • Thank you for addressing these: to be honest, I tried to make edits and add/remove links just whenever I thought it was genuinely needed, but obviously, different copy-editors can have very different views on the same article. About the "cryoprobe" phrase, you're definitely right: I didn't mention English is not my first language, so I've likely misunderstood the original text... Well done reversing my mistake. Oltrepier (talk) 12:26, 21 August 2023 (UTC)

So, let's start with some general notes: the article is very well-structured and focused, and the documentation you provided looks pretty good. I'm a bit concerned about the fact that some citations single-handedly cover very large chunks of text (look at the start of this section and this paragraph, for example), but it's probably not a big deal: you can just repeat each citation a few times through their respective text blocks, if needed. Also, there are instances where the same bits of information seem to be repeated in different - areas of the article (about OVDs, in this case), which could be useful in some cases, but still leads to the risk of redundancy.

• The general rule om English Wikipedia is to put a citation at the end of an uninterrupted preceding piece of content within a paragraph that is covered by the source, so if it covers the whole paragraph, once at the end is necessary and sufficient. This can be confused with supporting the whole paragraph when it only supports the end section, but there is no specific guidance on that. More frequent citation can avoid this problem, but not everyone approves. The paragraphs you mention are as far as I remember cases where the reference supports all the preceding content in that paragraph, and could fairly be added after every punctuation in the paragraph, to go to the opposite extreme. Personally I do not really care. If you prefer each sequential sentence to be individually cited to the same source, we can do that. In medical articles this has been done quite often, and has been the cause of edit wars with some editors, who have subsequently been blocked. In this article, I could probably find half a dozen MEDRS compliant references for each sentence in those paragraphs, but I doubt that it would improve the article in any meaningful way. Let me know where in the paragraphs you think repetition of the citation would be appropriate, and I will cheerfully do it, or alternatively you could do it yourself if you are willing to accept my word or check the sources for relevance.· · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
• Repetition of information does occur, and in the case you mention, the one place is a section describing the relevance of OVDs to the procedure, where some detail is clearly relevant, and the other mentions their historical relevance, where I put in what I thought to be some necessary or useful clarification for the reader who does not read the whole article in sequence and does not know what OVDs are. It is a judgement call whether the second description is redundant. I though it useful, just like you appear to consider the redundant links useful, and they will be useful to some readers and not to others. Avoiding repetition of some information can tighten up an article but can also make it very dense and more difficult to read. I don't see an urgent need to make a change at GA level. For FA it becomes more debatable, so I propose to leave it till then, when it will be considered by a wider range of editors.· · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
  • Oh, I wasn't fully aware about that rule, so I've usually had a careful approach to citations while reviewing GA and DYK nominations; that's fine as it is, then. The same goes for repetition of information: the fact that readers could just jump to a specific section of an article completely went out of my mind while I was reviewing this, so sorry for it... Oltrepier (talk) 12:26, 21 August 2023 (UTC)

I've inserted a few "warning" templates throughout the "History" and "Regional practice and statistics" sections, because I thought some of the physicians (and regions) you mentioned were addressed a bit too vaguely: I would try to write as many full names as possible. On a side note, it was a nice idea to include footnotes, although I think they need to be integrated with citations, too.

• I will try to identify the people more fully, but sources often do not provide full names, just the names people use in their publications, so probably will not succeed. This is definitely out of scope for GA, but I approve of the general principle as it will be an improvement, and will redlink. Some day the links may work. Maybe you will find some names.· · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
  • I have expanded the names you tagged as far as is reasonably practicable and left them as redlinks. I could not find any similar tags in the regional sections. · · · Peter Southwood ^(talk): 09:54, 21 August 2023 (UTC)
• I am not clear on what you mean by nice idea to include footnotes, although I think they need to be integrated with citations, too. Integrated with citations in what way? · · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
  • Well done! Actually, ignore what I said about footnotes: only on second thought, I realized it made no sense at all... Oltrepier (talk) 12:26, 21 August 2023 (UTC)

Finally, I wanted to make a few questions about some odd phrases I found here and there:

- "Posterior capsule rupture can cause lens fragments to be retained, corneal oedema, and cystoid macular oedema" Is "lens fragments to be retained" one of the rupture's consequences, or was it a typo?

• I thought I had already explained this, but I cant find it, so here goes. It is not a typo. Fragments of the lens can pass through a rupture into the vitreous, where they can be difficult to extract, sometimes requiring intervention from a specialist, and sometimes causing medical complications due to this retention, or due to vitreous extruding into the anterior of the eye. Do you think a detailed explanation of the possible complications is necessary or desirable? · · · Peter Southwood ^(talk): 09:54, 21 August 2023 (UTC)
  • Ok, got it: it's probably fine as it is. Oltrepier (talk) 12:26, 21 August 2023 (UTC)

- "PVD may be more problematic with younger patients because many patients older than 60 have already gone through PVD." Isn't it kind of an obvious statement?

• Obvious is in the eye of the beholder. The author of the source thought it was worth mentioning, and it was not so obvious to me either, so I mentioned it. We need to consider the ordinary reader, and I know I tend to overestimate their capacity and background knowledge.· · · Peter Southwood ^(talk): 17:52, 21 August 2023 (UTC)

- "In very thick opacified posterior capsules, a manual surgical capsulectomy might be needed. A posterior capsulotomy must be taken in consideration in the event of IOL replacement [...]" Are "capsulectomy" and "capsulotomy" interchangeable terms?

• I would not have thought so. -otomy generally means to cut the thing, while -ectomy means to cut the thing out. I will check the quoted content in context and see what sense it makes. · · · Peter Southwood ^(talk): 17:52, 21 August 2023 (UTC)
  • As far as I can tell, usage of both words is correct in the context. Do you think explanatory footnotes or links are necessary?

- "Endophthalmitis' typical presentation occurs within two weeks after the procedure [...] Hypopyon occurs about 80% of the time. Common infective agents include coagulase-negative staphylococci and Staphylococcus aureus in about 80% of infections." So, those two types of staphylococci count for 80% of all endophthalmitis infections, right?

• As far as I can tell, that is what the sources say. · · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
  • Perfect, it was just to make sure I understood correctly, so thank you for clarifying. Oltrepier (talk) 12:26, 21 August 2023 (UTC)

- "A ten-year prospective survey on refractive outcomes [...] showed a mean difference between the targeted and outcome refraction of −0.07 dioptres, with a standard deviation of 0.67, and a mean absolute error of 0.50 dioptres. 88.76% were within one diopter of target refraction and 62.36% within 0.50 dioptres." Do those two last percentage values refer to "refractive outcomes"?

• As far as I know, yes. I may have misinterpreted the source, but you can check that. Is there something about the way it is written that suggests otherwise? · · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
  • No, it's just another instance where I didn't make the connection immediately... All good! Oltrepier (talk) 12:26, 21 August 2023 (UTC)

- "Although direct evidence for cataract surgery in ancient Egypt is lacking, the indirect evidence, including surgical instruments that could have been used, show that it was possible. It is assumed that the couching technique was used." I didn't understand this phrase, to be honest...

• Indirect evidence is instruments that could be used for the procedure, and a wall painting that can be interpreted as showing the procedure. Direct evidence would be text describing it, or a mummified body with eyes that are sufficiently preserved to show that the lenses had been surgically removed. The indirect evidence is compatible with couching, but not with other procedures. Also, that is what the sources say. Can you suggest how it could be clarified? · · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
  • Oh, ok, got it. I would just complete the phrase as "instruments that could have been used for the procedure", and that would be enough. Oltrepier (talk) 12:26, 21 August 2023 (UTC)
    • Ok, done that. · · · Peter Southwood ^(talk): 17:52, 21 August 2023 (UTC)

- "According to surveys of members of the American Society of Cataract and Refractive Surgery, approximately 2.85 million cataract procedures were performed in the United States throughout 2004, while 2.79 million operations were executed in 2005." Actually, this phrase is alright, but I still wanted to flag it because its supporting citation is marked as a dead link: if possible, can you replace it?

• I have already tried without success. Dead links are a thing we have to live with. If you feel that it is likely to be inaccurate, you may remove it. To me the numbers are entirely plausible, and I have seen no reason to consider them controversial, or even of much importance in the bigger picture. · · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
  • Yes, what I'm worried about is that having dead links here and there is always a bit awkward, but I think you're right. Oltrepier (talk) 12:26, 21 August 2023 (UTC)

- "There have been occasional incidents in which patients have been infected and developed endophthalmitis [...], but the effects upon sterility of equipment or plausible infection pathways have not been reported." I think this entire block could be trimmed and made a bit easier to read, to be honest...

• I will look into this. · · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
  • I have made a small adjustment which I hope will clarify the situation a bit. That paragraph was originally a rather pointed bit of unbalanced and undue criticism by someone with an apparent agenda against the system, who filed to take into account that things can occasionally go wrong without actual malfeasance necessarily being involved. I tried to balance it by adding a bit of relevant context and leaving the reader to draw their own conclusions based on what information was available. The statistics must speak for themselves as no-one has provided a convenient summary in a reliable source. · · · Peter Southwood ^(talk): 17:52, 21 August 2023 (UTC)

- "The higher cataract-surgery coverage found in some settings in South Africa, Libya, and Kenya suggest many barriers to surgery can be overcome." The coverage in those areas was higher than... in the rest of the African regions involved in the studies, right?

• The context is Africa, which is the section title.· · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
  • Got it, thank you. Oltrepier (talk) 12:26, 21 August 2023 (UTC)

- "In 2011, Lecuona and Cook identified an inadequate level of human resources in the public sector to provide care for the indigent population." Given the context of that paragraph, "inadequate level" refers to a lack of preparation and training for surgeons, rather than a lack of staff members, doesn't it?

• I think it is more complicated than that. There are a lot of surgeons in private practice with well equipped clinics in relatively wealthy urban areas, who do not treat the indigent because they are not charities, and could do more surgeries if someone was prepared to cover the expenses. Some of them do pro bono work at state hospitals, but not all. If you have the money you can get world class surgery with a waiting time of about a week, if not, you can wait over a year. 6 months if you are lucky, 2 or more years if you are in the wrong place. The detail I have provided is what is available from the sources, which do not cover everything. · · · Peter Southwood ^(talk): 08:48, 21 August 2023 (UTC)
  • Yes, you explained it perfectly: by the way, we see similar problems involving private and public hospitals here in Italy, as well... Oltrepier (talk) 12:26, 21 August 2023 (UTC)

Ok, that's all for now: I hope I've addressed my doubts and corrections clearly enough. Let me know what do you think about this! Oltrepier (talk) 19:51, 20 August 2023 (UTC)

@Pbsouthwood: Oh, I almost forgot: when I first took a quick look at the article, it still had some missing sources in the paragraph describing phacoemulsification, so I went on to search some studies involving the technique: let me know if they could still be useful to improve the page! 1; 2; 3; 4.

• I looked at the abstracts, but it is not clear what information you consider is in scope for this article, rather than Phacoemulsification. · · · Peter Southwood ^(talk): 09:54, 21 August 2023 (UTC)
• Which paragraph describing phacoemulsification is lacking sources? Please tag in the article. · · · Peter Southwood ^(talk): 10:14, 21 August 2023 (UTC)

No, that section hasn't got issues with sourcing anymore: I think there were one or two "citation needed" tags when I read the article for the first time, but then you fixed those before I wrote this review, so no worries! And I'm aware the abstracts were specifically for phacoemulsification: I just thought they could be useful to add some more bits of information if you needed it. They're just "bonus" material, though. Oltrepier (talk) 12:26, 21 August 2023 (UTC)

I did also find a 2008 article describing surgical conditions in Sub-Saharan Africa, which actually included information about cataract surgery in India and Nepal. I hope it helps! Oltrepier (talk) 20:05, 20 August 2023 (UTC)

• I will take a look. · · · Peter Southwood ^(talk): 09:54, 21 August 2023 (UTC)

• I took a look. The information in the findings is much the same as information already mentioned in the article. If there is more that you think should be mentioned, you can add it any time. · · · Peter Southwood ^(talk): 10:00, 21 August 2023 (UTC)

What problems relating to Manual of Style (Item 1b) remain outstanding? I don't remember seeing anything in your comments.· · · Peter Southwood ^(talk): 10:14, 21 August 2023 (UTC)

None, I think... It mainly involved the few "green-lighted" statements I've cited up above, and now we should have cleared them all. Thank you so much for going through every query! Oltrepier (talk) 12:26, 21 August 2023 (UTC)

You are welcome, and thank you for reviewing. It is a team job even though the team is small. For future reference, I find it easier to keep track if each review point discussion has a header, and each section discussion has a header. Makes it easier to find things, and saves time when editing. Cheers,· · · Peter Southwood ^(talk): 18:19, 21 August 2023 (UTC)

@Pbsouthwood: Thank you for the advice: I admit I'm still struggling with the source editor... Anyway, I think we're definitely good to go now, so let's pass this review. Excellent job! Oltrepier (talk) 19:00, 21 August 2023 (UTC)

Oltrepier, I have the opposite problem. If I try to edit with VE I usually find there is something I cannot do, so I almost always edit in source, which was all that was available when I started here. There is a bit of a steep learning curve, but also great versatility. Also I worry if I don't use it, I'll lose it. Thanks again for your input, and if you think of a good hook for DYK you are welcome to nominate on my behalf. I am not really into that side of things. Cheers, · · · Peter Southwood ^(talk): 04:45, 22 August 2023 (UTC)