Female Gender Remains a Significant Barrier to Access Cataract Surgery in South Asia: A Systematic Review and Meta-Analysis

Qunru Ye; Yanxian Chen; William Yan; Wei Wang; Jingxian Zhong; Cong Tang; Andreas Müller; Bo Qiu

doi:10.1155/2020/2091462

Female Gender Remains a Significant Barrier to Access Cataract Surgery in South Asia: A Systematic Review and Meta-Analysis

J Ophthalmol. 2020 Jan 11:2020:2091462. doi: 10.1155/2020/2091462. eCollection 2020.

Authors

Qunru Ye^{1

2}, Yanxian Chen³, William Yan^{4

5

6}, Wei Wang³, Jingxian Zhong², Cong Tang², Andreas Müller^{4

5}, Bo Qiu¹

Affiliations

¹ The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
² Jiangmen Xinhui Aier New Hope Eye Hospital, Jiangmen, Guangdong, China.
³ Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China.
⁴ Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia.
⁵ WHO Collaborating Center for Prevention of Blindness, Centre for Eye Research Australia (CERA), University of Melbourne, Melbourne, Australia.
⁶ Department of Ophthalmology, University of Melbourne, Melbourne, Australia.

Abstract

Purpose: To determine whether the female gender is a barrier for the access to cataract surgery services in South Asia in the last two decades.

Methods: Eligible cross-sectional studies were identified via computer searches and reviewing the reference lists of the obtained articles. The cataract surgical coverage (CSC) by sex based on person and eyes at visual acuity <3/60 and 6/18 is extracted. Pooled odds ratios (ORs) for males receiving cataract surgery in comparison with females were calculated by a random effect model.

Results: Sixteen studies with 135972 subjects were included in the final analysis. The pooled ORs of CSC by sex on a person basis at visual acuity <3/60 and at visual acuity <6/18 were 1.46 (95% CI: 1.23-1.75) and 1.14 (95% CI: 1.05-1.24), respectively. For CSC on a per-eye basis at visual acuity <3/60, the associations were statistically significant, with a pooled OR of 1.40 (95% CI: 1.16-1.70). The values of population attributable risk percentage at a per-person and per-eye basis at visual acuity <3/60 were 6.28% and 7.48%, respectively. Subgroup analyses by design and location types attained similar results as the primary analyses. There was no evidence of publication bias.

Conclusions: The female gender remains a significant barrier for the access to cataract surgery in South Asia. Visual impairment, including blindness, from unoperated cataract, could be reduced by approximately 6.28% with the elimination of gender disparities to access. More efforts are needed to increase eye care service utilization by female population.

Publication types

Review