March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Affordability of Cataract Surgery using the Big Mac Index
Author Affiliations & Notes
  • Van C. Lansingh
    Agency for the Prevention of Blindness/VISION 2020, Weston, Florida
  • Marissa J. Carter
    Strategic Solutions, Inc, Cody, Wyoming
  • Kevin L. Winthrop
    Casey Eye Institute, Portland, Oregon
  • Joao M. Furtado
    Casey Eye Institute, Oregon Health & Science Univ, Portland, Oregon
  • Footnotes
    Commercial Relationships  Van C. Lansingh, None; Marissa J. Carter, Strategic Solutions, Inc. (E); Kevin L. Winthrop, None; Joao M. Furtado, None
  • Footnotes
    Support  Casey Eye Institute Vision 2020 International Fellowship (JMF)
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 6935. doi:
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      Van C. Lansingh, Marissa J. Carter, Kevin L. Winthrop, Joao M. Furtado; Affordability of Cataract Surgery using the Big Mac Index. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6935.

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      © ARVO (1962-2015); The Authors (2016-present)

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Cataract is the leading cause of blindness worldwide. One of the barriers to deliver cataract surgery for blind patients is the high price of the procedure found in some countries. We aimed to compare the costs of cataract surgery in different countries using the Big Mac index, an indicator created by The Economist to measure the purchasing power parity between different currencies.


We searched peer-reviewed articles containing information regarding the cost of cataract surgery. The following databases were searched from 1993 to November 2011: Pubmed, Lilacs, Bireme, Google Scholar, WebMD, Healthline, LATINDEX, PUBLINDEX, as well as Scholars Portal, DOAJ Directory of Open Access Journals, Free E-journals, Elsevier Science Direct, Ovid and Scielo. We also contacted cataract surgeons in different countries to provide us information about the costs of this surgical procedure. Costs (phacoemulsification) were adjusted to U.S dollars for 2010, and were also weighted during averaging depending on source and year in which costs were obtained. The dollar exchange rate and the price of the Big Mac in different countries were obtained at The Economist website (published online on July 28th 2011). All countries where both information (costs of cataract surgery and Big Mac price) could be obtained were included in this study.


We collected information on the following countries: Argentina, Australia, Brazil, Canada, Chile, China, Colombia, Denmark, India (Maharaja Mac), Israel, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, Sweden, United States, United Kingdom, and also from the Euro zone. Cataract surgery costs varied from USD 50 (Nepal) to USD 3,425 (USA), while Big Mac prices ranged from USD 1.89 (India) to $7.64 (Sweden). There was no linear correlation between Big Mac price and surgical costs of cataract; best fit was a power curve with an R squared of 0.213 (p = .032).


The price of cataract surgery in general terms does not take into consideration the capacity of the patient to pay based on purchasing power using a simple tool such as the Big Mac Index. This translates into affordability and access to service issues, particularly when patients work for minimum wages and do not have access to free government health care.  

Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • cataract • clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology 

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