Abstract
Purpose :
To investigate the incidence and factors associated with undergoing cataract surgery in a large nationwide cohort.
Methods :
This is a retrospective study comprising participants from the National Institutes of Health All of Us research program with a diagnosis of cataract, as determined by billing codes from electronic health records. Age, sex at birth, race/ethnicity, education, sexual orientation, employment, income, relationship status, and insurance coverage were determined from electronic health records and self-reported surveys. Cataract surgery rates were determined from billing codes for the overall cohort and stratified by age, race, and sex categories. Kaplan-Meier survival and multivariable Cox proportional hazard models were used to investigate factors associated with time to cataract surgery.
Results :
In a cohort of 37,204 participants with cataract in the nationwide All Of Us cohort, 19.8% (N=7,363) underwent cataract surgery. The overall cataract surgery rate was 30.6 per 1000 person-years and was higher for persons aged 70-79 (58.5), males (31.8), and Hispanics (39.0). Amongst the race/ethnicity categories, non-Hispanic Black participants had the lowest cataract surgery rate per 1000 person-years (24.4). In a multivariable Cox model, an increased hazard of undergoing cataract surgery was observed among Hispanic participants (hazard ratio [HR] 1.31; 95% confidence interval [CI] 1.21, 1.42), whereas a decreased hazard for undergoing cataract surgery was observed for non-Hispanic Black participants (HR 0.88; CI 0.81, 0.95) compared to non-Hispanic White participants. Decreased hazard of cataract surgery was observed among females compared to males (HR 0.94; CI 0.90, 0.99). Compared to being employed for wages, being self-employed (HR 1.13; CI 1.00, 1.27), out-of-work (HR 1.12; CI 1.02, 1.22), or retired (HR 1.24; CI 1.15, 1.34) was associated with increased hazard of cataract surgery. No clear patterns were observed in cataract surgery by education or income status.
Conclusions :
These findings provide evidence of persistent disparities in cataract surgery, particularly by race and ethnicity. These associations indicate a crucial need for interventions to address health disparities to ensure equitable access to cataract surgery.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.