March 7, 2023

Black and Hispanic Patients Had Worse Vision Results After the Same Eye Surgery as White Patients

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A new study from Boston Medical Center on surgery for retinal detachment underscores the importance of understanding how demographic data can shape health outcomes.


The Bottom Line

Black and Hispanic patients treated with surgery for retinal detachment had worse vision results when compared with white patients treated with the same surgery.

Context

Without surgical intervention, retinal detachment can cause permanent vision loss.  Though anyone can suffer from a retinal detachment—aging, family history, nearsightedness, prior eye injuries all continue to the condition—there has been limited data on the efficacy of these surgeries for patients of color. Previous research shows worse outcomes for patients of color, but many of those studies were completed outside of the U.S., where access to medical care may disproportionately influence outcomes.

Study Objective

To better understand how socioeconomic and demographic factors impact surgical outcomes for patients with retinal detachments. 

The Details

Researchers at Boston Medical Center examined the charts of 124 Black and Hispanic patients and 71 white patients who were treated surgically for retinal detachment at BMC between 2013 and 2021. They compared patient demographics, preoperative characteristics, and surgical outcomes, primarily looking at the success of a single operation and visual acuity at the six-month and final follow-ups.

Findings

Black, Hispanic, and white patients all had similar success rates for a single operation, but Black and/or Hispanic patients showed worse visual acuity at post-operative visits. Researchers suggest that it could be because Black and/or Hispanic patients were 35% more likely to have retinal scarring, known as proliferative vitreoretinopathy, pre-operatively, which could affect outcomes.

Experts also found differences in wait time for intervention. While all patients were treated within an acceptable timeframe for this type of surgery, white patients had surgery in an average of two days, compared to five days for Black and/or Hispanic patients. Researchers suggest this discrepancy could be associated with socioeconomic status. Black and/or Hispanic patients had lower mean household incomes ($80,932 as opposed to $92,911).

Pull Quote

“An understanding of patient and group-specific risk factors can help surgeons better choose the appropriate procedure to best achieve their goals of vision preservation and restoration,” said lead author Steven Ness, MD, an ophthalmology specialist at Boston Medical Center in a recent press release.


Source:

Xu J, Samaneh D, Yoon J, Chen X, Siegel N, Subramanian M, Ness S (2023). “Effect of race and ethnicity on surgical outcomes for rhegmatogenous retinal detachments.” Canadian Journal of Ophthalmology.

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