Abstract
Purpose :
To compare race-related differences in 1-year outcomes following cataract surgery in individuals of black and white descent.
Methods :
A retrospective cohort study was conducted using the TriNetX national database. Patients who underwent cataract surgery were initially stratified into black (n = 40,764) and white (n = 213,657) cohorts. Cohorts were then matched by demographics and comorbidities (age, gender, BMI, history of hypertension, diabetes mellitus, chronic lower respiratory disease, heart failure, nicotine dependence) using 1:1 propensity score matching (PSM). 40,132 patients in each cohort were included in the study for a total of 80,264. Primary outcome measures were vitreous hemorrhage (VH), choroidal hemorrhage, retinal detachment or tear (RD/RT), iridocyclitis, macular edema (ME), cystoid macular degeneration, epiretinal membrane (ERM) toxic maculopathy, ischemic optic neuropathy (ION), glaucoma, strabismus, hemorrhage of orbit, corneal edema, dry eye syndrome (DES), central retinal vein occlusion (CRVO), central retinal artery occlusion (CRAO), vitreous opacities, ptosis, dislocation of lens, endophthalmitis, and retinal vascular occlusions (RVO). Risk ratios (RR) using 95% confidence intervals (CI) were used to compare primary outcomes 1 year after cataract surgery.
Results :
80,264 total patients were included with 40,132 patients in each of the black and white cohorts following PSM. The black cohort had a significant greater risk for developing VH (RR, 1.49; 95% CI, 1.28-1.73), RD/RT (1.17; 1.02-1.33), iridocyclitis (4.67; 4.21-5.18), ME (1.48; 1.34-1.65), cystoid macular degeneration (1.73; 1.59-1.88), ION (1.71; 1.13-2.6), glaucoma (2.14; 1.98-2.31), DES (1.21; 1.13-1.28), CRVO(2.86; 2.01-4.08), dislocation of lens (1.63; 1.24-2.13), endophthalmitis (1.64; 1.31-2.06), and RVO (1.81; 1.47-2.24). The white cohort had a significant risk of developing ERM (0.71; 0.64-0.79), corneal edema (0.64; 0.47-0.87), and ptosis (0.8; 0.7-0.92). No significant difference was seen in choroidal hemorrhage, toxic maculopathy, strabismus, CRAO, and vitreous opacities.
Conclusions :
Race should be considered when evaluating long-term outcomes following cataract surgery. Blacks were more likely to develop VH, RD, ME, cystoid macular degeneration, ION, glaucoma, DES, CRVO, lens dislocation, endophthalmitis, and RVO whereas whites were more likely to develop ERM, corneal edema, and ptosis.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.