Do gender inequities exist in cataract surgical coverage? Meta-analysis in Latin America


  • Conflict/competing interest: MJC reports that she has been paid consultancy fees by the International Agency for the Prevention of Blindness (IAPB) and ORBIS; VCL reports that he is employed by the IAPB (VISION 2020 program); HL reports that he has only received consultancy fees for RAAB training and initial development of RACCS/RAAB software, which is now in the public domain.

  • Funding sources: This study was funded in part by ORBIS.

Dr Marissa Carter, Strategic Solutions, Inc., 1143 Salsbury Ave, Cody, WY 82414, USA. Email:


Background:  To determine if gender inequities exist in Latin America in regard to cataract surgery.

Design:  Meta-analysis.

Participants:  Total of 38 992 subjects participating in epidemiological surveys; summary measures were used (not patient-level data).

Methods:  A literature search and knowledge of rapid assessment of cataract surgical services/rapid assessment of avoidable blindness studies carried out in Latin America found 11 studies with complete cataract surgical coverage (CSC) data. Using summary original study data, a meta-analysis (random effects model) was conducted to analyse the differences in CSC between males and females. Results were adjusted for design effect.

Main Outcome Measures:  Odds ratio (OR) of receiving cataract surgery comparing women with men.

Results:  CSC with a visual acuity (VA) <3/60 on an eye basis showed a non-statistically significant OR of 1.01 (95% confidence intervals [CI]: 0.86–1.18) for women receiving cataract surgery in comparison with men. For VA < 6/18, a non-statistically significant OR of 0.94 (95% CI: 0.83–1.07) was obtained for women receiving cataract surgery. On a person basis at a VA of <3/60 and <6/18, non-statistically significant ORs of 1.12 (95% CI: 0.78–1.63) and 0.94 (95% CI: 0.77–1.15) were obtained for women receiving cataract surgery, respectively. Statistical heterogeneity was 0% (I2 statistic), except for results at a VA of <3/60 on a person basis (I2 = 30%).

Conclusions:  In the Latin American countries in which CSC was assessed, gender does not appear to be a significant factor in receiving cataract surgery. However, more data are required to confirm these results.