Relative importance of VA, patient concern and patient lifestyle on referral for cataract surgery

Purpose: The purpose of this study was to quantify the relative importance of visual acuity, patient concern and patient lifestyle in the odds of ophthalmologist referral for cataract surgery. Methods: A questionnaire was posted to all Australian ophthalmologists (n=569) regarding their management of patients with cataracts. They were asked to indicate the VA at which they would recommend surgery for three lifesiyle categories (employed, retired, nursing home) and patient complaint for nuclear (NC) and posterior subcapsular cataracts (PSC). Multiple logistic regression was used to determine the relative importance of acuity, patient complaint and lifestyle on the odds of referral, while controlling for surgeon location (urban/rural), number of years since completing training, and annual volume of cataract surgery. Results: 81% responded. The relative importance of the various factors was the same for both NC and PSC, although the strength /aried slightly. The relative odds of referral (OR) and 95% confidence limits are presented in the following table. Nuclear PSC Patient concern (more) OR=6.16 (6.12,6.73) OR = 4.56 (3.63,5.73) Lifestyle (employed) OR=6.25 (5.56,6.67) OR=2.48 (1.87,3.29) Visual acuity (worse) OR=2.27 (2.87,3.04) not available Conclusions: Patient concern and 1 festyle are the most important determinants for ophthalmologist referral for cataiact surgery.