The Role of Demographic Characteristics in the Outcomes of Cataract Surgery and Gender Roles in the Uptake of Postoperative Eye Care: A Hospital-based Study

Abstract

Purpose: To explore the effect of demographic characteristics on the outcomes of cataract surgery in terms of visual acuity and patient satisfaction, and gender role in the uptake of postoperative care.

Methods: Comprehensive ocular examinations were performed on 478 subjects (558 eyes) over the age of 50 years who underwent surgery for age-related cataract at the largest eye hospital in Iran. Demographic characteristics were obtained and surgical records were reviewed.

Results: Male subjects had significantly better outcomes in terms of uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) (mean difference 0.12 and 0.13 logMAR; p = 0.004 and p < 0.001, respectively). Women were significantly less satisfied than men (73.2% vs. 83.6%; p = 0.011). Postoperative UCVA and BSCVA were better in patients with higher levels of education (both p < 0.001). Age had an inverse association with UCVA (p = 0.004) and BSCVA (p < 0.001). Women were twice as likely to need capsulotomy (p = 0.002). Men’s uptake of postoperative refractive care was 4-fold that of women’s (31% vs. 7%). In multivariable analyses, age, sex, education, presence of ocular comorbidity and need for capsulotomy, spectacle prescription and other care were associated with postoperative UCVA (all p < 0.05; adjusted R² = 0.256).

Conclusion: Female patients were shown to be at a clear disadvantage in cataract surgery; outcomes of the procedure and postoperative care were both poorer. Older age, lower level of education, ocular comorbidity and unmet postoperative need were also associated with a poorer outcome.

KEYWORDS::

• Cataract surgery outcome
• Gender
• Unmet need
• Uptake
• Postoperative care
• Posterior capsule opacification
• Refractive care

ACKNOWLEDGMENTS

It is noteworthy that this study was the MPH thesis of the third author [H.Z.M.] who would like to acknowledge Prof. Akbar Fotouhi for his supervision.

Declaration of interest: The study was supported in part by a grant from Iran’s Ministry of Health (#7491) awarded to the Eye Research Center of Tehran University of Medical Sciences for achieving the second rank in Razi Medical Sciences Research Festival 2006. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.