Objectives:-To compare, in the region of Mopti region (Mali), the impact of a cataract surgery practised in a regional hospital (strategy 1 or fixed strategy) with a surgery close to the patients at the district level (strategy 2 or advanced strategy) on patient reported quality of life and visual functioning as well as on social rehabilitation. Methods:-Two samples of 100 and 199 people operated on for cataract in the fixed and advanced strategies respectively, were included in this study and

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... ere submitted at questioned on perceived vision and quality of life (IOTAQOL). Results:-Social conditions improved dramatically in both strategies, Most of men were able again to sustain their families (86,0% and 93,9% in strategies 1 and 2 respectively) and women to participate in housekeeping (87,8% and 88,2% respectively). The gains in QOL scores were high and equivalent in both strategies. These scores were strongly linked with the presence of an intraocular lens, with the ability to work and to fulfil his/her family duty. The gains in Perceived vision scores were equals in both strategies and strongly linked with postoperative visual acuity and with the presence of an intraocular lens. Conclusion:-Cataract surgery allows a dramatic socioeconomic reinsertion and a quality of life improvement whatever the strategy adopted. Cataract is the main cause of blindness worldwide accounting for more than 50% of this blindness (1). In West African countries such as Mali the number of persons operated on cataract is quite small despite the presence of ophthalmic surgical facilities in most of the regional hospitals. We hypothesised that one of the barrier was the distance to travel for reaching the regional hospital and that moving a surgical team from the regional hospital toward the district medical centres by diminishing the distance and the cost for the patients could significantly increase the demand.