Eyeworld

20 | EYEWORLD | DECEMBER 2023 ASCRS NEWS Contact Goshe: GOSHEJ@ccf.org steroid eye drops at 4 weeks postop (p<.0002). The authors postulated this difference may be attributed to the fact that LEP patients were more likely to have complicated surgeries and higher CDE. However, the language barrier itself may have independently contributed to mis- understandings about when to taper and stop steroid eye drops. LEP patients had a greater improvement in CDVA when compared with EP patients, without a higher complication rate. Though this largely reflects LEP patients' more advanced cata- racts due to delayed access to specialty care, it demonstrates that improving outreach can have a profound impact on these patients' quality of life. In addition, LEP patients were less likely to undergo Nd:YAG capsulotomy, highlighting the ophthalmology community's need for contin- ued LEP patient education regarding posterior capsular opacification and the benefits of laser capsulotomy. continued from page 19 References continued 8. Jacobs EA, et al. Limited English proficiency and breast and cervical cancer screening in a multiethnic population. Am J Public Health. 2005;95:1410–1416. 9. Kandula NR, et al. Differ- ences in self-reported health among Asians, Latinos, and non-Hispanic Whites: the role of language and nativity. Ann Epidemiol. 2007;17:191–198. 10. Kandula NR, et al. Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whites: cultural influences or access to care? Cancer. 2006;107:184–192. 11. Timmins CL. The impact of language barriers on the health care of Latinos in the United States: a review of the literature and guidelines for practice. J Midwifery Womens Health. 2002;47:80–96. 12. Wilson E, et al. Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med. 2005;20:800–806. 13. Adler NE, Rehkopf DH. U.S. disparities in health: descrip- tions, causes, and mecha- nisms. Annu Rev Public Health. 2008;29:235–252. Comparison of cataract surgery outcomes in English proficient and limited English proficiency patients Gill ZS, et al. J Cataract Refract Surg. 2023;49:595–601. n Purpose: To determine differences in cataract surgery outcomes between English proficient (EP) and limited English proficiency (LEP) patients. n Setting: Sue Anschutz-Rodgers Eye Center, Aurora, Colorado. n Design: Retrospective. n Methods: Patients who underwent phacoemulsification at the Sue Anschutz-Rogers Eye Center between January 2014 and February 2020 were included. Patients who self-identified as needing or preferring an interpreter in medical encounters were defined as LEP. Differences in surgical characteristics and outcomes including cataract maturity, surgical complexity, and surgical complications were analyzed. n Results: 868 eyes (6.4%) were identified from LEP patients. LEP patients were more likely to have mature cataracts (5.1% vs. 2.3%, P<.0001). LEP patients' surgeries were more likely to be considered complex (27.8% vs. 15.3%, P<.0001) and use higher cumulative dissipated energy (mean of 9.5 [SD=9.5] vs. 7.2 [SD=7.1], P<.0001). Preoperative visual acuity was worse in LEP patients (logMAR 0.566 [SD=0.64] vs. 0.366 [SD=0.51], P<.0001) but showed greater improvement after surgery (logMAR 0.366 [SD=0.54] vs. 0.254 [SD=0.41], P<.0001). There were no significant differences in operative time, intraoperative or postoperative complications. More LEP patients were on steroids 4 weeks postoperatively when compared with EP patients (14.6% vs. 10.1%, P<.0002). LEP patients were less likely to undergo subsequent YAG capsulotomy (7.3% vs. 12.8%, P<.0001). n Conclusions: Disparities in cataract outcomes between EP and LEP patients was demonstrated. Further research into ophthalmic health disparities for LEP patients is needed to understand the root causes and how they can be addressed. The authors noted several limitations to their study. The findings may not be generaliz- able as the LEP rates didn't match the Denver metro area or the state of Colorado. Additional- ly, there was a large difference in sample sizes between LEP and EP groups. The relatively small LEP cohort size limited any ability for ro- bust subgroup analysis. Furthermore, the study did not capture the modality of interpretation used, which can drastically influence a patient's comprehension level. Finally, they did not assess other social determinants of health, such as income, insurance status, transportation, and level of education, all of which may be con- founding variables. Nonetheless, Gill et al. have illuminated the disparities that exist between LEP patients and EP patients with regard to cataract surgery. Fu- ture research is necessary to further identify and address disparities within ophthalmology.

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