The consequences of waiting for cataract surgery: a systematic review.
BACKGROUND
Cataract surgery is the most common operative procedure performed in Canada, and how patients are affected by wait times for this surgery has important clinical, public health and health policy considerations. We conducted a systematic review to understand the relation between wait time for cataract surgery and patient outcomes and the variables that modify this relation.


METHODS
We performed an electronic search of 11 databases and the proceedings of 4 conferences. The search was restricted to studies published after the transition to phacoemulsification (1990). We assessed the quality of the included studies using the Jadad Scale for randomized controlled trials and the Newcastle-Ottawa Scale for cohort and case-control studies. The data were found to be inappropriate for meta-analysis, thus we performed a qualitative synthesis.


RESULTS
We found a total of 27 studies that met our inclusion criteria. When these studies were reviewed, a dichotomy was observed for the wait time-outcome relation: outcomes associated with wait times of <or= 6 weeks were better than outcomes associated with wait times of >or= 6 months. Patients who waited more than 6 months to receive cataract surgery experienced more vision loss, a reduced quality of life and had an increased rate of falls compared with patients who had wait times of less than 6 weeks. The outcomes associated with wait times between 6 weeks and 6 months remain unclear.


CONCLUSIONS
Patients who wait more than 6 months for cataract surgery may experience negative outcomes during the wait period, including vision loss, a reduced quality of life and an increased rate of falls.
Hodge
William
W
Department of Ophthalmology, University of Ottawa Eye Institute, Ottawa, Ont. whodge@ottawahospital.on.ca
Horsley
Tanya
T
Albiani
David
D
Baryla
Julia
J
Belliveau
Michel
M
Buhrmann
Ralf
R
O'Connor
Michael
M
Blair
Jason
J
Lowcock
Elizabeth
E
D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D002170:Canada / Q000453:epidemiology; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D018570:Risk Assessment; D013997:Time Factors; D014850:Waiting Lists