Effective cataract surgical coverage in India: Evidence from 31 districts

Vivek Gupta; Praveen Vashist; S Sarath; Noopur Gupta; Suraj Singh Senjam; Pallavi Shukla; Sumit Grover; B R Shamanna; Rajshekhar Vemparala; Meenakshi Wadhwani; Amit Bhardwaj; Promila Gupta; Jeewan S Titiyal

doi:10.4103/IJO.IJO_2835_23

Effective cataract surgical coverage in India: Evidence from 31 districts

Indian J Ophthalmol. 2024 Apr 16. doi: 10.4103/IJO.IJO_2835_23. Online ahead of print.

Authors

Affiliations

¹ Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
² School of Medical Sciences, University of Hyderabad, Hyderabad, Telangana, India.
³ Department of Ophthalmology, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
⁴ Department of Ophthalmology, Guru Nanak Eye Center, New Delhi, India.
⁵ National Program for Control of Blindness and Visual Impairment, Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi, India.

PMID: 38622863
DOI: 10.4103/IJO.IJO_2835_23

Abstract

Background: Effective Cataract Surgical Coverage (eCSC) is a core outcomes domain indicator to assess accessibility and quality of eye care services with limited available information.

Purpose: To generate baseline estimates of eCSC for India.

Methods: We performed the analysis of data pooled from Rapid Assessment of Avoidable Blindness surveys conducted in 31 districts of India during 2015-2019 among persons aged 50+ years. eCSC was calculated at various thresholds, the primary being operable cataract at best corrected visual acuity <6/12, good outcome at presenting visual acuity of 6/12.

Results: Age-sex standardized and weighed eCSC in India was 36.7% (95% CI: 33.6, 39.9), and cataract surgical coverage (CSC) was 57.3% (95% CI: 53.3, 61.2), a relative quality gap in cataract surgery being 36.0%. eCSC in males was higher at 38.0% than females (35.6%). eCSC increased with education from 31.0% in illiterate participants to 59.7% in class 10 educated. On multivariate analysis, rural setting, increasing age, and residence in eastern or northeastern zones of India continued to be associated with poor/worse eCSC, while female gender was associated with higher eCSC. District-wide variations in eCSC were observed.

Conclusion: Developmental factors have an important bearing on eCSC in India. Geographical variations point toward the need for targeted, locally relevant strategies.