Relationship of sociodemographic variables with outcomes after cataract surgery

Abstract

The objective of this study is to analyse the relationship between sociodemographic characteristics of patients undergoing cataract extraction and their outcomes. The method comprised a prospective cohort study of patients recruited from 17 hospitals of different areas of Spain. Data gathered before surgery included sociodemographic variables, visual acuity, and visual function (using the Visual Function Index-14). After surgery, we assessed visual acuity and visual function at 6 weeks and at 3 months, respectively. Multivariate multilevel analysis was performed to assess the relationship of sociodemographic variables with changes in visual acuity and function, analysing whether improvements surpassed the minimal clinically important differences (MCIDs). Multivariate analysis showed that for visual acuity, (i) older men had a lower odds ratio (OR) of surpassing the MCID (OR: 65-75 years, 0.64; >75 years, 0.51); (ii) those with primary (1.65) or secondary (1.41) education had higher ORs than those with no formal education; and (iii) those living in a residential home had a lower OR than men living alone (0.36). In women, we found that the higher the educational level, the greater the improvement in visual acuity (primary, 1.41; secondary, 1.76), whereas socially dependent women (0.70) were less likely to exceed the MCID. With regards to predictors related to achievement of an MCID in visual function, only dependency was associated with more improvement in men (OR: 1.39), whereas in women the educational level was the only predictor (primary: 0.72; secondary: 0.61). This study found that patients with certain sociodemographic characteristics were less likely to experience an MCID in visual acuity or visual function after cataract surgery.