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Courtney Kauh, Taylor Blachley, Paul Lichter, Paul Lee, Joshua Stein; Geographic Variability In The Age Of First Cataract Surgery And Rate Of Cataract Surgery Among Persons Living In Communities Throughout The U.S.. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4384.
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To determine whether there is geographic variability in the age of first cataract surgery and the age-adjusted rate of cataract surgery among a large group of patients living in different communities throughout the United States.
Health care claims data from a large nationwide managed-care network were reviewed to identify all enrollees age >40 who underwent ≥1 cataract surgery between 2001-2011. The age of first cataract surgery was obtained for each enrollee and comparisons of the median age of first cataract surgery were made for enrollees residing in each of the 306 different communities throughout the U.S.
Of the 1052277 enrollees diagnosed with cataracts, 243467 (23.1%) underwent ≥1 cataract surgery. Large differences were noted in the median age of first cataract surgery among the different communities: those with the lowest median age of first cataract surgery (Lansing, MI- 59.9 years and Aurora, IL- 60.1 years) differed considerably from those with the highest median age (Marquette, MI-77.0 years, Rochester, NY-78.4 years and Binghamton, NY-79.6 years). Differences in the age-standardized rates of cataract surgery varied 5 fold across communities ranging from 7.5% in Honolulu, HI to 37.3% in Lake Charles, LA. Some communities exhibited variability in age of first cataract surgery of as little as 6-7 years (Lawton, OK- 6.4 years and Yakima, WA- 7.2 years) while others had large variability in the age of first cataract surgery (Bloomington, IL- 12.7 years and Santa Cruz, CA- 12.7 years).
Dramatic variability exists in the age of first cataract surgery and the age-standardized rate of cataract surgery for enrollees residing in different communities throughout the U.S. Efforts should be directed at understanding the extent by which these differences are due to patient-related factors, supply of ophthalmologists or optometrists in a given community, and the impact of the timing of cataract surgery on patient outcomes.
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