Meta-analysis of Cataract Surgical Coverage in Latin America

1. Van Lansingh¹
2. Marissa Carter²
3. Hans Limburg³
4. Juan Silva⁴
5. Serge Resnikoff⁵

¹International Agency for the Prevention of Blindness, Buenos Aires, Argentina
²Strategic Solutions, Inc., Cody, WY, USA
³Health Information Services, Inc., Grootebroek, The Netherlands
⁴Pan American Health Organization, Santa Fe de Bogotá DC, Colombia
⁵Formerly WHO, Geneva, Switzerland

Purpose: To determine if gender inequalities exist in Latin America in regard to cataract surgery.

Methods: Using original Rapid Assessment of Cataract Surgical Services/Rapid Assessment of Avoidable Blindness data from 11 countries, a meta-analysis (fixed effects model and random effects model in 1 case) was conducted to analyze the differences in cataract surgical coverage (CSC) between males and females (9046 eyes). Main outcome measure was odds ratio (OR) of having had cataract surgery with males and females as the comparison groups.

Results: CSC with a visual acuity < 20/400 on an eye basis showed a nonsignificant OR of 1.03 (95% confidence intervals [CI]: 0.91-1.17) for women obtaining cataract surgery in comparison to men. For visual acuity < 20/60, a nonsignificant OR of 1.03 (95% CI: 0.93-1.14) favoring men compared to women was obtained. On a person basis at a VA of < 20/400 and < 20/60, nonsignificant ORs of 1.10 (95% CI: 0.78-1.55) and 1.04 (95% CI: 0.89-1.20) were obtained in favor of women and men, respectively. Heterogeneity was low or moderate in all cases except on a person basis at a visual acuity of < 20/400, in which significant heterogeneity was encountered (I2 = 48%) and a random effects model was employed.

Conclusions: In Latin America, gender does not appear to be a significant factor in obtaining cataract surgery, although more research needs to be conducted to confirm these preliminary results.