Consequences of cataract surgery public policies run by private contractors

Kara-Júnior, Newton; Almeida, Hirlana Gomes; Jorge, Priscilla de Almeida; Carricondo, Pedro Carlos; Kara‐José, Newton

doi:10.5935/0004-2749.20170001

Cited by 4 publications

(5 citation statements)

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“…At such level, the municipalities public health leaders could choose to prioritize other conditions instead of cataract. As a result, we observe a fluctuating, up-down trend of cataract output from 2006 and on [28][29][30].…”

Section: Plos Global Public Healthmentioning

confidence: 89%

“…The data evaluated in the current study refers only to the cataract procedures performed through the Brazilian Health System and do not include those performed by nonpublic services as private insurances or under out-of-pocket conditions. Previous studies estimate that two-thirds of cataract surgeries are carried out through SUS, while one-third are performed in private hospitals or private insurance system facilities [29,30]. No official national data is available as those private services are not required to deposit their data on a unified database as DATASUS.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

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Trends in cataract surgical treatment within the Brazilian national public health system over a 20-year period: Implications for Universal Eye Health as a global public health goal

Ferraz¹,

Lemos²,

Watanabe³

et al. 2022

PLOS Glob Public Health

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Cataract is a highly prevalent, treatable, and sight threatening condition considered one of the main focuses of public health policies addressing visual impairment and blindness towards Universal Eye Health. We aimed to investigate the trends on number of cataract surgical procedures performed through the Brazilian national health system (SUS) from 2000 to 2019 while also evaluating costs associated with it. The Brazilian Public Health System Information Database (DATASUS) was used as the primary data source for procedures including extracapsular cataract extraction (ECCE) and phacoemulsification. Trends along the years were evaluated through generalized linear models. A total of 8,424,521 cataract procedures were performed from 2000 to 2019, with a significant increase along the years from 228,145 in 2000 to 663,186 in 2019 (p<0.001), a cataract surgical procedure rate change from 13.15 to 32.28 procedures per 10,000 people. It was observed a significant increase on the number of phacoemulsification (p<0.001) and a significant decrease on the number of ECCE (p<0.001). A shift on the predominant technique has occurred between 2007 and 2008 with phacoemulsification increasing its percentual representativity from 34.3% to 69.7% of all procedures, reaching 96.1% in 2019. Phacoemulsification costs per procedure increased 30.5% from from USD$119.00 to USD$155.33 (p = 0.007) and the ECCE costs per procedure increased 29.1% from USD$78.57 to USD$101.43 (p = 0.001). There is an increasing trend of procedures related to cataract treatment performed through SUS along the 20-years period and a switch on the technique predominance from ECCE to phacoemulsification was observed after 2007. The costs associated with both techniques have increased but have not followed the country’s overall inflation. Data derived from DATASUS is important to understand the overall panorama of ocular health offered by the national health system and to provide information to guide healthcare leaders on management and planning of public health policies within the system.

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Section: Plos Global Public Healthmentioning

confidence: 89%

Section: Plos Global Public Healthmentioning

confidence: 99%

Trends in cataract surgical treatment within the Brazilian national public health system over a 20-year period: Implications for Universal Eye Health as a global public health goal

Ferraz¹,

Lemos²,

Watanabe³

et al. 2022

PLOS Glob Public Health

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“…At the current rate of subspecialist training, which we observe to be disproportionate to social needs, in the near future, many subspecialist ophthalmologists, mainly in large urban centers, may have to choose to work for a health plan or for a large institution (8)(9)(10). To act as a liberal professional in a private practice, the subspecialist must have good quality specialization training and must also be a good generalist.…”

mentioning

confidence: 93%

Are ophthalmologists being trained for Brazil's social needs?

Kara-Júnior

2020

Clinics

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“…Despite intense research interest ( Makley et al, 2015 ; Shanmugam et al, 2015 ; Zhao et al, 2015 ), no preventative or therapeutic drugs against cataract have been approved to-date, leaving surgery as the only treatment option. Aggregate costs of cataract surgery are high in high-income countries ( Frick et al, 2007 ), while availability and outcomes are often poor in low- and middle-income ones ( Kara-Junior et al, 2017 ; Lam et al, 2015 ). Hence, most cataract around the world remains untreated ( WHO, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

A native chemical chaperone in the human eye lens

Serebryany

Chowdhury

Woods

et al. 2022

eLife

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Cataract is one of the most prevalent protein aggregation disorders and still the most common cause of vision loss worldwide. The metabolically quiescent core region of the human lens lacks cellular or protein turnover; it has therefore evolved remarkable mechanisms to resist light-scattering protein aggregation for a lifetime. We now report that one such mechanism involves an unusually abundant lens metabolite, myo-inositol, suppressing aggregation of lens crystallins. We quantified aggregation suppression using our previously well-characterized in vitro aggregation assays of oxidation-mimicking human γD-crystallin variants and investigated myo-inositol's molecular mechanism of action using solution NMR, negative-stain TEM, differential scanning fluorometry, thermal scanning Raman spectroscopy, turbidimetry in redox buffers, and free thiol quantitation. Unlike many known chemical chaperones, myo-inositol's primary target was not the native, unfolded, or final aggregated states of the protein; rather, we propose that it was the rate-limiting bimolecular step on the aggregation pathway. Given recent metabolomic evidence that it is severely depleted in human cataractous lenses compared to age-matched controls, we suggest that maintaining or restoring healthy levels of myo-inositol in the lens may be a simple, safe, and globally accessible strategy to prevent or delay lens opacification due to age-onset cataract.

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Consequences of cataract surgery public policies run by private contractors

Cited by 4 publications

References 0 publications

Trends in cataract surgical treatment within the Brazilian national public health system over a 20-year period: Implications for Universal Eye Health as a global public health goal

Trends in cataract surgical treatment within the Brazilian national public health system over a 20-year period: Implications for Universal Eye Health as a global public health goal

Are ophthalmologists being trained for Brazil's social needs?

A native chemical chaperone in the human eye lens

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