Socioeconomic Factors Affecting Visual Acuity in Cataract Camps.

BACKGROUND

Cataracts are the leading cause of reversible blindness worldwide. Though temporary and resource-intensive, cataract camps provide large-scale treatment of the condition. This study sought to determine socioeconomic factors that affect short-term improvements in visual acuity observed in cataract camps across 17 countries.

METHODS

This observational study represents 52 camps in 17 low- and middle-income countries. Mixed-effects linear regression models were used to analyze associations between changes in LogMAR score of uncorrected visual acuity (UCVA) one to four days post-operation and socioeconomic factors including per capita GDP, Human Development Index, Cataract Surgical Rate, and density of in-country ophthalmologists.

FINDINGS: Among 4110 patients, after accounting for age and sex, LogMAR UCVA significantly decreased over the first four days postoperatively (p < 0·0001). This decrease was also associated with the number of ophthalmologists per million performing cataract surgery (p = 0·0227). Patients who underwent extracapsular cataract extraction (ECCE) exhibited a greater decrease in LogMAR UCVA per day post-op (p < 0·0001). Per capita GDP was not significantly associated with the change in LogMAR UCVA per day post-op.

INTERPRETATION: Our analyses suggest that cataract camps in areas with fewer ophthalmologists performing cataract surgery and ECCE surgeries correlated with the most improvement in vision. Targeting such populations and training local ophthalmologists to perform ECCE surgery may yield a higher impact in low-resource settings with a high burden of cataract-induced blindness.