Gupta Sachin, Ravilla Ravindran D, Aravind Haripriya, Chandrashekharan Shivkumar, Ravilla Thulasiraj D
Cornell SC Johnson College of Business, Ithaca, NY, USA.
Aravind Eye Care System, Madurai, India.
Lancet Reg Health Southeast Asia. 2025 Jan 17;33:100530. doi: 10.1016/j.lansea.2025.100530. eCollection 2025 Feb.
Data on the evolving characteristics of patients seeking cataract surgery, surgical techniques used, preoperative vision, postoperative visual outcomes, and surgery costs provide critical insights for improving care delivery and making progress towards global eye care targets. We aimed to establish long-term trends in these factors.
Retrospective analysis of all cataract surgeries performed at Aravind Eye Hospitals during 2012-2023.
In 3.6 M cataract surgeries, the mean preoperative uncorrected visual acuity improved from 1.32 logMAR units (Snellen fraction ≈ 6/120) in 2012 to 1.15 (Snellen fraction ≈ 6/85) in 2023. The trend was observed in females and males, with females presenting with worse vision than males, in all age groups, and among outreach, subsidized and paying patients. Postoperative visual acuity outcomes steadily improved, with larger gains in Manual Small Incision Cataract Surgeries than in phacoemulsification. Mean prices for paying patients rose slightly faster than the Consumer Price Index for health. Surgeries supported by insurance and government assistance increased from 4.4% in 2012 to 28.7% in 2023. Male patients consistently paid about 10% higher prices than female patients because they chose more expensive intraocular lenses.
Over this period, patients sought cataract surgery sooner, received better surgical outcomes, and were willing to pay more for the improvements. However, female patients continued to face inequities, presenting with worse vision, and receiving lower expenditures for surgery, indicating the need for targeted approaches to address sex inequity both on the demand generation and treatment provision sides.
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有关寻求白内障手术的患者不断变化的特征、所采用的手术技术、术前视力、术后视觉效果以及手术费用的数据，为改善医疗服务和朝着全球眼保健目标取得进展提供了关键见解。我们旨在确定这些因素的长期趋势。
对2012年至2023年在阿拉文德眼科医院进行的所有白内障手术进行回顾性分析。
在360万例白内障手术中，术前平均未矫正视力从2012年的1.32 logMAR单位（Snellen视力表分数≈6/120）提高到2023年的1.15（Snellen视力表分数≈6/85）。在所有年龄组以及外展、补贴和自费患者中，女性和男性均呈现出这一趋势，且女性视力比男性更差。术后视力结果稳步改善，手法小切口白内障手术的改善幅度大于超声乳化手术。自费患者的平均价格上涨速度略快于医疗保健消费者价格指数。由保险和政府援助支持的手术从2012年的4.4%增加到2023年的28.7%。男性患者支付的价格始终比女性患者高出约10%，因为他们选择了更昂贵的人工晶状体。
在此期间，患者更早地寻求白内障手术，获得了更好的手术效果，并且愿意为这些改善支付更多费用。然而，女性患者仍然面临不平等，视力更差，手术支出更低，这表明需要采取有针对性的方法来解决需求产生和治疗提供方面的性别不平等问题。
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