Sex Disparities in Operating Room use Among Cataract Surgeons: A 10-Year Retrospective Population-Based Analysis

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Health Equity

Background:

• Cataract surgery is a common procedure with significant impact on patient quality of life.
• Understanding surgeon practice patterns, including operating room (OR) time and case volume, is crucial for healthcare resource allocation.
• Previous studies have not comprehensively evaluated sex-based differences in OR utilization among comprehensive cataract surgeons.

Purpose of the Study:

• To investigate potential sex-based disparities in operating room (OR) time and annual case volumes among comprehensive cataract surgeons in Ontario, Canada.
• To analyze how these differences vary by surgeon sex and career stage.

Main Methods:

• A retrospective, population-based cohort study utilizing physician billing data from Ontario, Canada (2010-2019).
• Analysis included all cataract surgeries performed during the study period.
• Primary outcomes were the number of OR days and total case volume, stratified by surgeon sex and career stage.

Main Results:

• Over 1.05 million cataract surgeries were performed by an average of 195 surgeons annually, with the proportion of female surgeons increasing from 16.8% to 24.4% during the study.
• Female surgeons averaged 32 OR days per year compared to 44.9 for male surgeons, a difference of 12.45 fewer days annually.
• While average case volume per OR day was similar, male surgeons performed significantly more surgeries annually (average 172.7 more cases).

Conclusions:

• Female comprehensive cataract surgeons in Ontario utilize less operating room time annually compared to their male counterparts.
• This discrepancy in OR time is consistent across all career stages and persisted throughout the 10-year study period.
• Transparent and equitable metrics for OR allocation and utilization are recommended to address potential sex-based inequities in surgical practice.