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Alexander James Silvester, Robert Scott, Anil Pitalia; North of England Deprivation Study of Cataract presentation and outcomes. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6014. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
We performed a retrospective, cohort study of patients who had cataract surgery in the North of England to observe if there was any impact from social deprivation on cataract presentation and surgical outcome.
A retrospective analysis of electronic patient records (Medisoft, Leeds, UK) for all 24,378 National Health Service patients who underwent cataract surgery at the SpaMedica group of ophthalmic units in the North of England, February 2012 to October 2017. Outcome measures included the level of deprivation (English Indices of Deprivation 2015), cataract severity (Lens Opacities Classification System), pre and postoperative uncorrected (UCVA), best corrected visual acuity (BCVA) and subjective refraction.
Patients from the lowest deprivation decile presented with more advanced cataract 9.32% versus 4.89% OR 1.69 ( 1.54 to 1.854) p<0.0001, reduced UCVA 69.9% versus 62.5% OR 1.39 (1.24 to 1.56) p<0.0001 and BCVA 42.14% versus 32.21% OR 1.53 (1.37 to 1.72) p<0.0001. Patients from the least deprived decile were more likely to have a post operative visual acuity better than 6/12, 94.6% versus 89.57% OR 2.04 (1.51 to 2.76) p<0.0001 and refractive outcome within 1 dioptre of predicted 93.7% versus 89.6% OR 1.75 (1.31 to 2.34) P=0.0002 than the most deprived.
Patients from areas of social deprivation present with poorer vision and more advanced cataracts and their visual outcomes are worse than patients from less deprived areas. Co-morbidities and education may play a role in this difference.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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