Objective To review and summarize perioperative nursing coordination experiences in large-scale vision-restoring cataract surgeries in high-altitude ethnic minority regions. This study explores nursing challenges and optimization strategies related to the high-altitude environment, the linguistic and cultural characteristics of minority patients, and the centralized surgical model, aiming to provide a theoretical basis and reference for blindness prevention and vision restoration initiatives in similar regions. Methods This study employed a retrospective descriptive design to analyze perioperative nursing data from large-scale vision-restoring cataract surgeries performed by the Zhongshan Ophthalmic Center, Sun Yat-sen University, in Tibetan-inhabited areas at an altitude of nearly 4,000 meters from July 2013 to September 2025. The analysis focused on key nursing components: screening preparation, preoperative assessment and health education, personal hygiene intervention, linguistic support, operating room environment and instrument management, intraoperative infection control, and postoperative observation and health guidance. These components were evaluated to identify strategies for optimizing nursing collaboration to promoting early postoperative visual recovery. Results A total of 2,951 patients (2,951 eyes) who underwent vision-restoring cataract surgery over the study period were included. All surgeries were performed using small-incision extracapsular cataract extraction with intraocular lens implantation. The operative duration ranged from 5 to 20 minutes (mean 7.2 ± 1.3 minutes). The preoperative personal hygiene compliance rate increased from 9.72% to 100%. On the first postoperative day, uncorrected visual acuity (UCVA) was 0.5–1.2 in 2,331 eyes (79.0%), 0.05-<0.5 in 590 eyes (20.0%), and <0.05 in 30 eyes (1.0%). The primary causes of suboptimal early visual recovery (UCVA <0.05) were postoperative ocular hypertension, ocular hemorrhage, and pre-existing retinal diseases. No cases of postoperative infectious endophthalmitis occurred. Conclusions Building upon conventional perioperative cataract nursing care, this study established a four-dimensional integrated nursing management model encompassing environment, culture, process, and infection control for large-scale vision-restoring cataract surgeries in high-altitude regions. Strengthening adaptive environmental management, cross-cultural communication, personal hygiene interventions, standardized patient handovers, surgical safety management, and infection control protocols facilitates surgical safety and early visual recovery. This model provides valuable practical insights for blindness prevention and treatment initiatives in similar regions.