Visual Acuity Outcomes After Cataract Surgery Similar Between Sexes Despite Differences in Comorbidities and Surgical Complexity.
- 1Department of Ophthalmology, University of Kansas School of Medicine, Kansas City, KS, USA.
Abstract
Purpose
The role of sex hormones in ophthalmic diseases is an emerging area of research; however, the magnitude of the impact of biological sex relative to other factors is unclear in cataract surgery. This study evaluated sex differences in pre-operative risk factors, surgical complexity, and outcomes of cataract surgery across the lifespan and identified other contributing factors.Patients and methods
This retrospective cohort study included patients ≥18 years of age who underwent cataract surgery at The University of Kansas Health System between 2015 and 2019. Chi-square, Fisher's exact, Mann-Whitney U, and t-tests compared demographics, systemic/ocular comorbidities, wait times, appointment adherence, complications, and visual acuity (VA) outcomes between sexes. Linear and logistic regressions identified predictors of post-operative VA and complications.Results
Of the 1606 patients, 639 (39.8%) were male and 967 (60.2%) were female. Wait times and appointment adherence were similar between sexes. While females had higher rates of ocular comorbidities (48.0% M vs 53.3% F; p = 0.041), and males had higher rates of complex surgery (44.1% M vs 34.1% F; p < 0.001) and intra-operative complications (16.7% M vs 10.8% F; p < 0.001), post-operative uncorrected VA (LogMAR 0.18 [IQR 0.05-0.35] M vs 0.18 [0.05-0.32] F; p = 0.986) and best corrected VA (0.10 [0.00-0.24] M vs 0.10 [0.00-0.24] F; p = 0.257) were similar between sexes, as was the percentage of patients who met their refractive target (77.8% M vs 79.9% F; p = 0.298). Age and sex were not identified as significant predictors of post-operative VA and complications, but ethnicity and specific comorbidities were.Conclusion
While sex differences were observed, the findings of this study suggest that socio-demographics and comorbidities are stronger drivers of differences in cataract surgery outcomes. Future work can evaluate how these disparities can be addressed to optimize outcomes for all patients.
Related
- Artificial intelligence across the cataract care continuum: a systematic scoping review introducing the CAICC framework and the surgical complexity prediction gap.
- What are the implementation lessons from a high-volume cataract screening and surgical programme? A mixed-methods implementation evaluation in Sierra Leone
- Gender differences in pre-surgical motivations, expectations, and patient-reported outcomes in Class III orthognathic surgery patients: An item-level analysis
- Exploring the link between comorbidities, tobacco usage, and surgical intervention in medial epicondylitis
- Air pollution exposure and cataract outcomes: a systematic review and pollutant-specific meta-analysis
BibTeX
@article{sy2026visual,
title = {{Visual Acuity Outcomes After Cataract Surgery Similar Between Sexes Despite Differences in Comorbidities and Surgical Complexity.}},
author = {Kaitlyn Abigail Sy and Chase Buntain and Yifan Yu and Norman Morikawa and Anna Johnson and Anne Wishna},
journal = {Clinical ophthalmology (Auckland, N.Z.)},
year = {2026},
month = oct,
doi = {10.2147/opth.s645308},
url = {https://europepmc.org/article/MED/42921524},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Visual Acuity Outcomes After Cataract Surgery Similar Between Sexes Despite Differences in Comorbidities and Surgical Complexity.
AU - Kaitlyn Abigail Sy
AU - Chase Buntain
AU - Yifan Yu
AU - Norman Morikawa
AU - Anna Johnson
AU - Anne Wishna
PY - 2026
DA - 2026/10/19
JO - Clinical ophthalmology (Auckland, N.Z.)
DO - 10.2147/opth.s645308
UR - https://europepmc.org/article/MED/42921524
AB - Purpose The role of sex hormones in ophthalmic diseases is an emerging area of research; however, the magnitude of the impact of biological sex relative to other factors is unclear in cataract surgery. This study evaluated sex differences in pre-operative risk factors, surgical complexity, and outcomes of cataract surgery across the lifespan and identified other contributing factors.Patients and methods This retrospective cohort study included patients ≥18 years of age who underwent cataract surgery at The University of Kansas Health System between 2015 and 2019. Chi-square, Fisher's exact, Mann-Whitney U, and t-tests compared demographics, systemic/ocular comorbidities, wait times, appointment adherence, complications, and visual acuity (VA) outcomes between sexes. Linear and logistic regressions identified predictors of post-operative VA and complications.Results Of the 1606 patients, 639 (39.8%) were male and 967 (60.2%) were female. Wait times and appointment adherence were similar between sexes. While females had higher rates of ocular comorbidities (48.0% M vs 53.3% F; p = 0.041), and males had higher rates of complex surgery (44.1% M vs 34.1% F; p < 0.001) and intra-operative complications (16.7% M vs 10.8% F; p < 0.001), post-operative uncorrected VA (LogMAR 0.18 [IQR 0.05-0.35] M vs 0.18 [0.05-0.32] F; p = 0.986) and best corrected VA (0.10 [0.00-0.24] M vs 0.10 [0.00-0.24] F; p = 0.257) were similar between sexes, as was the percentage of patients who met their refractive target (77.8% M vs 79.9% F; p = 0.298). Age and sex were not identified as significant predictors of post-operative VA and complications, but ethnicity and specific comorbidities were.Conclusion While sex differences were observed, the findings of this study suggest that socio-demographics and comorbidities are stronger drivers of differences in cataract surgery outcomes. Future work can evaluate how these disparities can be addressed to optimize outcomes for all patients.
SN - 1177-5467
SN - 1177-5483
ER -