Aim To assess the visual outcomes of cataract surgery among a national sample of non-Indigenous and Indigenous Australians.
Methods This was a population-based study of 3098 non-Indigenous Australians (50–98 years) and 1738 Indigenous Australians (40–92 years), stratified by remoteness. A poor postoperative outcome in an eye that had undergone cataract surgery was defined as presenting distance visual acuity (PVA) <6/12–6/60, and a very poor outcome was defined as PVA <6/60. Effective cataract surgery coverage (eCSC; operated cataract and a good outcome (PVA ≥6/12) as a proportion of operable plus operated cataract) was calculated.
Results The sampling weight adjusted cataract surgery prevalence was 19.8% (95% CI 17.9 to 22.0) in non-Indigenous Australians and 8.2% (95% CI 6.0 to 9.6) in Indigenous Australians. Among the non-Indigenous population, poor and very poor PVA outcomes were present in 18.1% and 1.9% of eyes, respectively. For Indigenous Australians, these values were 27.8% and 6.3%, respectively. The main causes of poor vision were refractive error (non-Indigenous=41.8%; Indigenous=41.9%) and coincident disease (non-Indigenous=43.3%; Indigenous=40.3%). The eCSC rates in the non-Indigenous and Indigenous populations were 88.5% (95% CI 85.2 to 91.2) and 51.6% (95% CI 42.4 to 60.7), respectively.
Conclusion Approximately half of eyes with a poor visual outcome postcataract surgery could be readily avoided through the appropriate refractive correction. The finding of a lower eCSC rate among Indigenous Australians suggests that improvements in access and quality of cataract services may be warranted in order to reduce cataract-related vision loss in the Indigenous population.
- public health
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Contributors All the authors have contributed to the planning, conducting and reporting of the work described in the article.
Funding This work was supported by the Department of Health of the Australian Government, an NHMRC Career Development Fellowship (#1090466, author MD), the Peggy and Leslie Cranbourne Foundation and Novartis Australia. The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian Government.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The protocol was approved by the Royal Victorian Eye and Ear Hospital Human Research Ethics Committee (HREC-14/ 1199 hours) as well as State-based Indigenous ethics organisations.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All data have been published within this article and the accompanying manuscripts.