Abstract
Purpose :
Cataract extraction is one of the most frequently performed procedures as more than 3 million patients receive cataract surgery each year. There is a significant amount of literature focusing on utilization rates of cataract surgery and intraoperative complication rates by racial group. Unfortunately, less is known about racial disparities regarding the timeline of cataract surgery and intraocular lens (IOL) selection. The purpose of this study is to determine if black patients have a different adherence to cataract surgery follow-up as well as IOL selection than white patients.
Methods :
This is a retrospective chart review that identified patients who underwent cataract surgery with insertion of an IOL by 2022 CPT code 66984 or 66982. 11,711 patients aged 18 to 100 years old were identified with 9879 (84.4%) being white and 6,751 (57.65%) being female. Each patient’s visual acuity, slit lamp exam findings, and number of days from surgical date to each follow-up date were recorded. Finally, the IOL selection was categorized as standard or premium by model number. An unpaired students t test and a chi squared test were performed on GraphPad Prism with a p value of less than 0.05 considered statistically significant.
Results :
Black patients and white patients referred for surgery had cataracts with a similar mean (SD) grade of 2.274 (0.786) and 2.283 (0.794), respectively. 93.35% (95% CI 92.018% - 94.480%) of black patients completed their post-op day 1 follow-up appointment compared to 91.12% (95% CI 90.398% - 91.796%) of their white counterparts (p=0.0043). 78.8% (95% CI 76.6 – 80.7%) of black patients followed up a second time in 10 or less days versus 80.6% (95% CI 79.6 – 81.5%) of white patients (p=0.1141). 98.9% (95% CI 98.2% - 99.3%) of black patients who underwent cataract surgery received a standard lens compared to 93.8% (95% CI 93.3% - 94.3%) of white patients (p<0.0001).
Conclusions :
Black patients had a similar cataract grade and visual impairment at the referral date. Contrary to our hypothesis, black patients had significantly better first follow-up rates and similar second follow-up rates compared to their white counterparts. Black patients were significantly less likely to receive a premium IOL compared to white patients.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.