Abstract
PURPOSE: Cataracts are a leading cause of blindness treatable with surgery. The purpose of this retrospective study was to investigate the association between cataract surgery and race/ethnicity, socioeconomic status, healthcare access, and other factors related to social determinants of health. METHODS: A total of 37,204 participants with at least one cataract diagnosis were included in this study from the All of Us Research Program using electronic health records and self-reported surveys. Kaplan-Meier and Cox models assessed risk factors for cataract surgery, while summary statistics showed surgery rates by age, race, and gender. The primary outcome was cataract surgery, identified by Current Procedural Terminology (CPT) codes. RESULTS: Of the included participants, 19.8% (N = 7,363) underwent cataract surgery. The overall cataract surgery rate for this cohort was 30.6 per 1000 person-years and was significantly higher for persons who were 70-79 years old (58.5 per 100 persons-years), male (31.8 per 1000 person-years), or Hispanic (39.0 per 100 person-years). Non-Hispanic Black participants had the lowest cataract surgery rate (24.4 per 1000 person-years). Cox models demonstrated an increased hazard of undergoing cataract surgery among Hispanic participants (adjusted HR 1.31; 95% CI [1.21, 1.42]) compared to non-Hispanic White participants. A decreased hazard for undergoing cataract surgery was observed for non-Hispanic Black participants (adjusted HR 0.88, 95% CI [0.81,0.95]) compared to non-Hispanic White participants. CONCLUSIONS: Age, race/ethnicity, and sex were significantly associated with time from cataract diagnosis to first cataract surgery. These findings highlight barriers and disparities in cataract surgery, emphasizing the need for interventions to promote health equity.