Patient Impact and Economic Burden of Waiting for Cataract Surgery in Canada: A Targeted Literature Review

ABSTRACT

Objectives: To collate and review published evidence to assess patient impact and economic burden of cataract surgery wait times in Canada. Methods: A targeted literature search was conducted using PubMed from January 1, 2007–December 10, 2021, and supplemented by grey literature search. Included studies were those reporting Canada-specific data. Results: Overall, six publications were included. All 6 reported patient impact related to waiting for cataract surgery in Canada, including decline in visual acuity(n=4);greater risk of falls(n=4), motor vehicle accidents(n=3), and depression(n=3);reduced quality life(n=3);interference with treating other eye diseases such as glaucoma, diabetic retinopathy, and AMD(n=1);permanent disability(n=1);and even increased risk of death(n=1). Eye Physicians and Surgeons of Ontario (2018) also highlighted challenges recent ophthalmology graduates face to secure operating room time. This can potentially lead to a lack of surgical competency resulting in more complications, greater incidence of unsuccessful surgeries, decline in ophthalmologists able to perform cataract surgery, and ultimately longer wait times. Canadian Council of the Blind reported an estimated 143,000 necessary eye surgeries missed or delayed in 2020 due to COVID-19, resulting in increased risk of vision loss (vision loss costing $27,251/person/year). It’s also projected from 2021 to 2023, costs of vision loss due to additional wait times of ophthalmic surgeries (most specifically cataract surgery) will be $520.2 million annually in Canada;owing 85% of these costs to loss of well-being ($442.2 million/year) and the remainder to direct healthcare system costs ($78 million/year). Further, average costs incurred by someone with vision loss until they receive surgery is $54/day. Conclusions: Increased cataract surgery wait times in Canada has negative implications, including worse patient outcomes and increased patient and healthcare system costs. There remains an urgent need to reduce wait times to ensure timely treatment access for individuals undergoing cataract surgery in Canada.