Non-surgical discharge causes in screening camp-recruited cataract patients: a study in North-Western India

To investigate the main reasons related to non-surgical discharge (NSDS) among patients recruited for cataract surgery in the Northwest Indian screening camps (SCs) and evaluate the potential actions that could be undertaken to improve the SC programs in India.

Retrospective cross-sectional analysis of patients' medical records selected for elective cataract surgery at Sankara Eye Hospital, a tertiary eye care center in Jaipur, Rajasthan, between January 1 and December 31, 2023. After SCs' thorough examination, recruited patients suitable for cataract surgery were further evaluated in the hospital to assess anesthetic and ophthalmic suitability. Reasons for NSDS, classified as patient-related, administrative-related, and anesthesia-related, were recorded. Univariate and multivariablelogistic regression were conducted to evaluate the effects of statistically significant variables on the reasons for NSDS.

13,219 patients were recruited from screening to undergo cataract surgery. Of 13,219, 1036 (7.8%) were discharged without surgical interventions. Patient-related reasons accounted for 57.14% of total causes, with 301 (29.06%) patients refusing to consent to surgery. 78 patients (7.5%) were discharged due to the lack of the required intraocular lens, whereas 288 patients (27.8%) reported a blood pressure > 140/90 mmHg, whereas 22 (2.1%) were discharged due to uncontrolled diabetes. Patients aged 65 years or older had 1.61-fold greater odds of being discharged due to anesthesia-related causes (95% Confidence Interval [CI]: 1.23-2.10, p < 0.001) compared to patients aged less than 65 years.

Albeit rare, NSDS-related factors should be considered to better counsel patients in SCs and prevent avoidable blindness in India.