Relationship between cataract severity and socioeconomic status

Wesolosky, Jason D.; Rudnisky, Christopher J.

doi:10.1016/j.jcjo.2013.07.001

Cited by 10 publications

(3 citation statements)

References 26 publications

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“…Race and socioeconomic factors have previously been associated with cataract prevalence, access to care, and severity at time of surgery . Few US studies have reported visual outcome difference by race and socioeconomic status, although worse outcomes are associated with poverty in low- and middle-income countries .…”

Section: Discussionmentioning

confidence: 99%

Refractive Outcomes After Immediate Sequential vs Delayed Sequential Bilateral Cataract Surgery

et al. 2021

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IMPORTANCE Approximately 2 million cataract operations are performed annually in the US, and patterns of cataract surgery delivery are changing to meet the increasing demand. Therefore, a comparative analysis of visual acuity outcomes after immediate sequential bilateral cataract surgery (ISBCS) vs delayed sequential bilateral cataract surgery (DSBCS) is important for informing future best practices. OBJECTIVETo compare refractive outcomes of patients who underwent ISBCS, short-interval (1-14 days between operations) DSBCS (DSBCS-14), and long-interval (15-90 days) DSBCS (DSBCS-90) procedures. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used population-based data from the American Academy of Ophthalmology Intelligent Research in Sight (IRIS) Registry. A total of 1 824 196 IRIS Registry participants with bilateral visual acuity measurements who underwent bilateral cataract surgery were assessed. EXPOSURES Participants were divided into 3 groups (DSBCS-90, DSBCS-14, and ISBCS groups) based on the timing of the second eye surgery. Univariable and multivariable linear regression models were used to analyze the refractive outcomes of the first and second surgery eye. MAIN OUTCOMES AND MEASURES Mean postoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) after cataract surgery. RESULTSThis study analyzed data from 1 824 196 patients undergoing bilateral cataract surgery (mean [SD] age for those <87 years, 70.03 [7.77]; 684 916 [37.5%] male). Compared with the DSBCS-90 group, after age, self-reported race, insurance status, history of age-related macular degeneration, diabetic retinopathy, and glaucoma were controlled for, the UCVA of the first surgical eye was higher by 0.41 (95% CI, 0.36-0.45; P < .001) letters, and the BCVA was higher by 0.89 (95% CI, 0.86-0.92; P < .001) letters in the DSBCS-14 group, whereas in the ISBCS group, the UCVA was lower by 2.79 (95% CI, −2.95 to −2.63; P < .001) letters and the BCVA by 1.64 (95% CI, −1.74 to −1.53; P < .001) letters. Similarly, compared with the DSBCS-90 group for the second eye, in the DSBCS-14 group, the UCVA was higher by 0.79 (95% CI, 0.74-0.83; P < .001) letters and the BCVA by 0.48 (95% CI, 0.45-0.51; P < .001) letters, whereas in the ISBCS group, the UCVA was lower by −1.67 (95% CI, −1.83 to −1.51; P < .001) letters and the BCVA by −1.88 (95% CI, −1.98 to −1.78; P < .001) letters. CONCLUSIONS AND RELEVANCEThe results of this cohort study of patients in the IRIS Registry suggest that compared with DSBCS-14 or DSBCS-90, ISBCS is associated with worse visual outcomes, which may or may not be clinically relevant, depending on patients' additional risk factors. Nonrandom surgery group assignment, confounding factors, and large sample size could account for the small but statistically significant differences noted. Further studies are warranted to determine whether these factors should be considered clinically relevant when counseling patients before cataract surgery.

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Section: Discussionmentioning

confidence: 99%

Refractive Outcomes After Immediate Sequential vs Delayed Sequential Bilateral Cataract Surgery

et al. 2021

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“…145 Increased cataract severity is also seen in individuals with lower levels of SES and lower income earned compared to those of higher levels of SES and higher income earned. 146 Furthermore, disparities in access to care and affordability of health care most often affect individuals of lower SES and income earned. 145,147,148 Such individuals are less likely to access cataract treatment 145 or undergo diabetic retinopathy screening 147 compared to their wealthier counterparts.…”

Section: Discussionmentioning

confidence: 99%

Risk factors common to leading eye health conditions and major non-communicable diseases: a rapid review and commentary

et al. 2022

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Background: To gain an understanding of the intersection of risk factors between the most prevalent eye health conditions that are associated with vision impairment and non-communicable diseases (NCDs). Methods: A series of rapid reviews of reviews reporting on non-modifiable risk factors, age and sex, and modifiable risk factors, including social determinants, were conducted for five common eye health conditions that are the leading causes of vision impairment globally (refractive error including uncorrected refractive error, cataract, age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy) and five prevalent NCDs (cancer, cardiovascular disease, chronic respiratory disease, dementia, and depressive disorders). Articles published within approximately 5 years to the end of 2019 were identified through expert recommendation, PubMED, Ovid Medline, the Lancet Global Burden of Disease series, the International Agency for Research on Cancer and World Cancer Research Fund. Results: Of 9,213 records identified, 320 records were eligible. Eye health conditions and NCDs share many risk factors. Increased age was found to be the most common shared risk factor, associated with increased risks of AMD, cataract, diabetic retinopathy, glaucoma, refractive error, cancer, cardiovascular disease, chronic obstructive pulmonary disease, and dementia. Other shared risk factors included smoking, obesity, alcohol consumption (mixed results), and physical activity was protective, though limited evidence was found for eye conditions. Social determinants are well documented as risk factors for NCDs. Conclusion: There is substantial overlap in common established risk factors for the most frequent vision impairing eye conditions and leading NCDs. Increasing efforts should be made to integrate preventative and risk reduction interventions to improve health, with greatest shared benefits for initiatives which aim to reduce smoking, improve diet, and promote physical activity.

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“…Low socioeconomic status, defined by factors such as income and employment status, has been linked to an increased prevalence of cataracts and increased severity and visual impairment. [8][9][10] There is also a significant association between insurance status and visual impairment because public insurance coverage has been associated with worse preoperative best-corrected visual acuity than private insurance coverage at the time of cataract surgery. 11 Race has also been shown to be a significant predictor of utilization of vision services because one study assessing national survey data demonstrated that non-Hispanic whites were more likely to undergo cataract surgery than non-Hispanic blacks.…”

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confidence: 99%

Patient Utilization of Premium Intraocular Lenses Before and During the COVID-19 Pandemic

Cha

Arsiwala

Srikumaran

et al. 2023

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Purpose:To compare the choice of intraocular lens (IOL) and sociodemographic characteristics between patients who underwent elective cataract surgery before the COVID-19 pandemic and during the pandemic at the Wilmer Eye Institute.Methods:A retrospective chart review of patients who underwent cataract surgery before the COVID-19 pandemic (June 1 to November 30, 2019) and during the pandemic (June 1 to November 30, 2020) was conducted. Sociodemographic information, including age, sex, race, and insurance, and choice of IOL (premium or standard) were analyzed. The association between timing of surgery and choice of IOL was analyzed using multivariable logistic regression.Results:The study included 2,877 patients (3,946 eyes) before COVID-19 and 2,564 patients (3,605 eyes) during COVID-19. However, 9.0% (357/3,946) of surgeries before COVID-19 used premium IOLs compared with 11.1% (399/3,605) during COVID-19 (P=0.004). There was no difference in the racial characteristics of patients between before and during COVID-19. After adjusting for time of surgery and demographics, the odds of choosing premium IOLs for black patients was 0.32 times the odds for white patients (P<0.001). There was an increase in private-insured patients but a decrease in Medicare-insured patients during COVID-19. After adjusting for time of surgery and demographics, private-insured patients had higher odds of choosing premium IOLs (P<0.001), whereas Medicaid-insured patients had lower odds (P=0.007) when compared with Medicare-insured patients.Conclusion:More patients chose premium IOLs during COVID-19 than before COVID-19, concurrent with change in insurance status. White patients were more likely to choose premium IOLs than black patients, as were private-insured patients compared with Medicare-insured patients.

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Relationship between cataract severity and socioeconomic status

Cited by 10 publications

References 26 publications

Refractive Outcomes After Immediate Sequential vs Delayed Sequential Bilateral Cataract Surgery

Refractive Outcomes After Immediate Sequential vs Delayed Sequential Bilateral Cataract Surgery

Risk factors common to leading eye health conditions and major non-communicable diseases: a rapid review and commentary

Patient Utilization of Premium Intraocular Lenses Before and During the COVID-19 Pandemic

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