Eyeworld

18 | EYEWORLD | DECEMBER 2023 ASCRS NEWS EYEWORLD JOURNAL CLUB by Matthew Regueiro, MD, and Chad Serels, MD Cleveland Clinic Cole Eye Institute residents Additionally, surgical outcomes were analyzed including postoperative complications, postop- erative CDVA, change in visual acuity, refractive surprise (target refraction spherical equiva- lent minus postoperative refraction spherical equivalent), use of steroid eye drops at 4 weeks postop, and whether patients received subse- quent Nd:YAG laser capsulotomy. These clinical characteristics and outcomes were analyzed by LEP and EP status. Racial and ethnic subanalyses (Hispanic, African American, Asian) were performed to investigate whether associations identified within the entire cohort remained after stratification. The threshold for statistical significance was set at a P value of <0.01. Results A total of 13,590 eyes were included. Of these, 868 (6.4%) were identified from LEP patients. The largest two groups of LEP patients were Hispanic (39.3%) and Asian (28.2%). Com- pared to EP patients, patients with limited English proficiency were more likely to have a history of type 2 diabetes, macular edema, EyeWorld Journal Club review Review of "Comparison of cataract surgery outcomes in English proficient and limited English proficiency patients" H ealthcare inequities in the U.S. are a pervasive issue that impacts disad- vantaged racial, ethnic, gender, socio- economic, and elderly populations. 1,2 Language discordance also poses a significant challenge and has a well-established relationship with sociodemographic dispari- ties, decreased access to healthcare, and worse health outcomes. 3–13 Though disparities are a well-documented challenge within the medical system, little literature exists within the field of ophthalmology. In this context, Gill et al. sought to investigate outcomes of patients with limited English proficiency (LEP) compared to those who are English proficient (EP) undergoing cataract surgery, one of the most common surgeries worldwide. Methods A retrospective analysis was performed us- ing the Cataract Surgery Outcomes Database created by the Department of Ophthalmology at the University of Colorado School of Medi- cine. Professional research assistants trained on cataract data abstraction queried the electronic medical record to identify patients with LEP, defined as patients who self-identified as need- ing or preferring an interpreter during medical encounters. All patients undergoing cataract surgery between January 1, 2014, and February 24, 2020, were included in the study and were divided into EP and LEP groups. Demographic and preoperative character- istics were analyzed, including sex, self-report- ed race, ethnicity, age, preoperative corrected distance visual acuity (CDVA), uveitis, macular edema, and diabetic retinopathy. The following surgical characteristics were collected: maturity of cataract, complexity of surgery, intraoperative complications, whether a resident or attending physician was the primary surgeon, surgical time, and cumulative dissipated energy (CDE). Jeffrey Goshe, MD Residency Program Director Cleveland Clinic Cole Eye Institute Cleveland, Ohio Though challenges with language discordance have been documented in other medical fields, there is limited literature within ophthalmology. The findings presented by Gill et al. exhibit preoperative, intraoperative, and postoperative disparities in cataract surgery between LEP and EP patients.

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