Do gender inequities exist in cataract surgical coverage? Meta-analysis in Latin America

Abstract

Background: To determine if gender inequities exist in Latin America in regard to cataract surgery.

Design: Meta-analysis.

Participants: Total of 38,992 subjects participating in epidemiological surveys; summary measures were used (not patient-level data).

Methods: A literature search and knowledge of rapid assessment of cataract surgical services/rapid assessment of avoidable blindness studies carried out in Latin America found 11 studies with complete cataract surgical coverage (CSC) data. Using summary original study data, a meta-analysis (random effects model) was conducted to analyse the differences in CSC between males and females. Results were adjusted for design effect.

Main outcome measures: Odds ratio (OR) of receiving cataract surgery comparing women with men.

Results: CSC with a visual acuity (VA) <3/60 on an eye basis showed a non-statistically significant OR of 1.01 (95% confidence intervals [CI]: 0.86-1.18) for women receiving cataract surgery in comparison with men. For VA < 6/18, a non-statistically significant OR of 0.94 (95% CI: 0.83-1.07) was obtained for women receiving cataract surgery. On a person basis at a VA of <3/60 and <6/18, non-statistically significant ORs of 1.12 (95% CI: 0.78-1.63) and 0.94 (95% CI: 0.77-1.15) were obtained for women receiving cataract surgery, respectively. Statistical heterogeneity was 0% (I(2) statistic), except for results at a VA of <3/60 on a person basis (I(2) = 30%).

Conclusions: In the Latin American countries in which CSC was assessed, gender does not appear to be a significant factor in receiving cataract surgery. However, more data are required to confirm these results.