The consequences of waiting for cataract surgery: a systematic review

Background: Cataract surgery is the most common operative procedure performed in Canada, and how patients are affected by wait times for this surgery has important clinical, public health and health policy considerations. We conducted a systematic review to understand the relation between wait time for cataract surgery and patient outcomes and the variables that modify this relation. Methods: We performed an electronic search of 11 databases and the proceedings of 4 conferences. The search was restricted to studies published after the transition to phacoemulsification ( 1990). We assessed the quality of the included studies using the Jadad Scale for randomized controlled trials and the Newcastle - Ottawa Scale for cohort and case - control studies. The data were found to be inappropriate for meta-analysis, thus we performed a qualitative synthesis. Results: We found a total of 27 studies that met our inclusion criteria. When these studies were reviewed, a dichotomy was observed for the wait time - outcome relation: outcomes associated with wait times of <= 6 weeks were better than outcomes associated with wait times of >= 6 months. Patients who waited more than 6 months to receive cataract surgery experienced more vision loss, a reduced quality of life and had an increased rate of falls compared with patients who had wait times of less than 6 weeks. The outcomes associated with wait times between 6 weeks and 6 months remain unclear. Interpretation: Patients who wait more than 6 months for cataract surgery may experience negative outcomes during the wait period, including vision loss, a reduced quality of life and an increased rate of falls.