Are there sex-based disparities in cataract surgery?
AIM: To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery. METHODS: This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado Sc...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Press of International Journal of Ophthalmology (IJO PRESS)
2024-01-01
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| Series: | International Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://ies.ijo.cn/en_publish/2024/1/20240119.pdf |
| _version_ | 1797376275135856640 |
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| author | Matthew D. Geiger Anne M. Lynch Alan G. Palestine Nathan C. Grove Karen L. Christopher Richard S. Davidson Michael J. Taravella Naresh Mandava Jennifer L. Patnaik |
| author_facet | Matthew D. Geiger Anne M. Lynch Alan G. Palestine Nathan C. Grove Karen L. Christopher Richard S. Davidson Michael J. Taravella Naresh Mandava Jennifer L. Patnaik |
| author_sort | Matthew D. Geiger |
| collection | DOAJ |
| description | AIM: To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery. METHODS: This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of Medicine. Data collected included the patient's health history, ocular comorbidities, operative and post-operative complications, and the post-operative best corrected visual acuity (BCVA). The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the study. RESULTS: A total of 11 977 eyes from 7253 patients were included in the study. Ocular comorbidities differed by sex, with males having significantly higher percentages of traumatic cataracts (males 0.7% vs females 0.1%), prior ocular surgery (6.7% vs 5.5%), and mature cataracts (2.8% vs 1.9%). Conversely, females had significantly higher rates of pseudoexfoliation (2.0% vs 3.2%). In unadjusted analysis, males had higher rates of posterior capsular rupture (0.8% vs 0.4%) and vitreous loss (1.0% vs 0.6%), but this difference was not significant after adjustment for confounders. Males had a significantly increased risk of post-operative retinal detachment, but in multivariable analysis this was no longer significant. Males were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy for posterior capsule opacification (OR=0.8, 95%CI=0.7-0.9, P=0.0005). The BCVA was slightly worse for males pre-operatively; but post-operatively, both sexes exhibited similar visual acuity of Snellen equivalent 20/25. CONCLUSION: The study finds that in a cohort of patients presenting for cataract surgery, sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for males. However, observed surgical complication rates exhibit almost no difference by sex after adjusting for pre-operative differences and post-operative BCVA is similar between sexes. |
| first_indexed | 2024-03-08T19:36:11Z |
| format | Article |
| id | doaj.art-34dfa63a2e37414fb1706a086824a722 |
| institution | Directory Open Access Journal |
| issn | 2222-3959 2227-4898 |
| language | English |
| last_indexed | 2024-03-08T19:36:11Z |
| publishDate | 2024-01-01 |
| publisher | Press of International Journal of Ophthalmology (IJO PRESS) |
| record_format | Article |
| series | International Journal of Ophthalmology |
| spelling | doaj.art-34dfa63a2e37414fb1706a086824a7222023-12-26T01:50:00ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982024-01-0117113714310.18240/ijo.2024.01.1920240119Are there sex-based disparities in cataract surgery?Matthew D. Geiger0Anne M. Lynch1Alan G. Palestine2Nathan C. Grove3Karen L. Christopher4Richard S. Davidson5Michael J. Taravella6Naresh Mandava7Jennifer L. Patnaik8Jennifer L. Patnaik. Department of Ophthalmology, University of Colorado School of Medicine, Mail Stop F731, 1675 Aurora Court, Aurora, CO 80045, USA. Jennifer.Patnaik@cuanschutz.eduDepartment of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USADepartment of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USADepartment of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USADepartment of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USADepartment of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USADepartment of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USADepartment of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USADepartment of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USAAIM: To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery. METHODS: This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of Medicine. Data collected included the patient's health history, ocular comorbidities, operative and post-operative complications, and the post-operative best corrected visual acuity (BCVA). The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the study. RESULTS: A total of 11 977 eyes from 7253 patients were included in the study. Ocular comorbidities differed by sex, with males having significantly higher percentages of traumatic cataracts (males 0.7% vs females 0.1%), prior ocular surgery (6.7% vs 5.5%), and mature cataracts (2.8% vs 1.9%). Conversely, females had significantly higher rates of pseudoexfoliation (2.0% vs 3.2%). In unadjusted analysis, males had higher rates of posterior capsular rupture (0.8% vs 0.4%) and vitreous loss (1.0% vs 0.6%), but this difference was not significant after adjustment for confounders. Males had a significantly increased risk of post-operative retinal detachment, but in multivariable analysis this was no longer significant. Males were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy for posterior capsule opacification (OR=0.8, 95%CI=0.7-0.9, P=0.0005). The BCVA was slightly worse for males pre-operatively; but post-operatively, both sexes exhibited similar visual acuity of Snellen equivalent 20/25. CONCLUSION: The study finds that in a cohort of patients presenting for cataract surgery, sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for males. However, observed surgical complication rates exhibit almost no difference by sex after adjusting for pre-operative differences and post-operative BCVA is similar between sexes.http://ies.ijo.cn/en_publish/2024/1/20240119.pdfcataract surgerysex-based disparityphacoemulsificationoutcomes |
| spellingShingle | Matthew D. Geiger Anne M. Lynch Alan G. Palestine Nathan C. Grove Karen L. Christopher Richard S. Davidson Michael J. Taravella Naresh Mandava Jennifer L. Patnaik Are there sex-based disparities in cataract surgery? International Journal of Ophthalmology cataract surgery sex-based disparity phacoemulsification outcomes |
| title | Are there sex-based disparities in cataract surgery? |
| title_full | Are there sex-based disparities in cataract surgery? |
| title_fullStr | Are there sex-based disparities in cataract surgery? |
| title_full_unstemmed | Are there sex-based disparities in cataract surgery? |
| title_short | Are there sex-based disparities in cataract surgery? |
| title_sort | are there sex based disparities in cataract surgery |
| topic | cataract surgery sex-based disparity phacoemulsification outcomes |
| url | http://ies.ijo.cn/en_publish/2024/1/20240119.pdf |
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