Late Presentation for Cataract Surgery: A Case-Control Study

To identify risk factors for delayed presentation for cataract surgery by comparing the clinical and sociodemographic characteristics of patients presenting early versus late. Postoperative outcomes are also compared between these groups.

Patients referred for cataract surgery at a high-volume community-based ophthalmology practice were enrolled in this retrospective case-control study. Patients with best corrected visual acuity (BCVA) of 20/200 or worse were classified as "late presenters." A control group of patients with BCVA better than 20/200 was also assessed. Patient age, sex, socioeconomic status, comorbidities, BCVA at week 1 post-surgery, and intraoperative complications were analyzed.

Two hundred and fifty late presenters and 250 early presenters were included. Multivariable regression showed that the late presenter group was slightly younger (mean age 68.7 vs. 71.0 years, p = 0.007) and had more systemic comorbidities (OR 1.33, 95% CI 1.04-1.71). Postoperative BCVA was worse in late presenters (median 20/40 vs. 20/25, p < 0.001), and late presenters also had significantly higher rates of perioperative complications (OR 2.77, 95% CI 1.20-6.39).

Late presenters for cataract surgery have more comorbidities, worse postoperative vision, and higher complication rates. System-wide efforts are needed to reduce delays in cataract treatment.