Table 2.
Hypothesis 2: Adjusted* odds ratio (95% confidence interval) for the association of ISBCS vs DSBCS surgery with postoperative visual outcomes (within-patient average between the two eyes), Kaiser Permanente Northern California, 2013-June 2015.
| MODEL 1 BCVA worse than 20/20 vs 20/20 or better (Includes 3,561 ISBCS and 13,711 DSBCS patients) |
MODEL 2 RE ametropia vs emmetropia (Includes 3,243 ISBCS and 12,717 DSBCS patients) |
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| Characteristics | OR | 95% CI | p-value | OR | 95% CI | p-value |
| Surgery | ||||||
| ISBCS | 0.91 | 0.83–1.01 | 0.07 | 1.02 | 0.92–1.12 | 0.75 |
| DSBCS | 1.00 | Ref. | 1.00 | Ref. | ||
| Year of surgery | ||||||
| 2013 | 1.00 | Ref. | 1.00 | Ref. | ||
| 2014 | 1.03 | 0.96–1.11 | 0.77 | 1.02 | 0.95–1.10 | 0.90 |
| 2015 | 1.08 | 0.98–1.20 | 0.16 | 1.05 | 0.96–1.16 | 0.40 |
| Patient age, years | ||||||
| ≤74 | 1.00 | Ref. | 1.00 | Ref. | ||
| 75–79 | 1.91 | 1.76–2.07 | <0.0001 | 0.93 | 0.86–1.01 | <0.001 |
| 80–84 | 2.80 | 2.54–3.09 | <0.0001 | 1.04 | 0.94–1.14 | 0.83 |
| 85+ | 5.18 | 4.46–6.00 | <0.0001 | 1.22 | 1.09–1.38 | <0.001 |
| Patient sex | ||||||
| M | 1.00 | Ref. | 1.00 | Ref. | ||
| F | 1.12 | 1.04–1.20 | 0.003 | 1.07 | 1.00–1.15 | 0.05 |
| Patient race/ethnicity | ||||||
| White | 1.00 | Ref. | 1.00 | Ref. | ||
| African-American | 1.30 | 1.11–1.53 | 0.91 | 1.20 | 1.02–1.40 | 0.02 |
| Asian-American | 1.82 | 1.64–2.02 | <0.0001 | 1.06 | 0.96–1.17 | 0.38 |
| Hispanic | 1.23 | 1.10–1.38 | 0.21 | 0.98 | 0.88–1.09 | 0.34 |
| Other | 1.32 | 1.15–1.51 | 0.92 | 0.90 | 0.79–1.02 | 0.01 |
| Charlson comorbidity | ||||||
| 0 | 1.00 | Ref. | 1.00 | Ref. | ||
| 1 | 1.08 | 0.98–1.18 | 0.24 | 0.93 | 0.85–1.02 | 0.09 |
| ≥2 | 1.28 | 1.17–1.40 | <0.0001 | 1.00 | 0.92–1.09 | 0.34 |
| Clinical history (yes/no) | ||||||
| Diabetes | 1.08 | 0.98–1.18 | 0.12 | 0.92 | 0.84–1.00 | 0.05 |
| Flomax | 1.03 | 0.91–1.17 | 0.65 | 0.93 | 0.83–1.06 | 0.27 |
| Warfarin | 1.13 | 0.88–1.44 | 0.34 | 0.93 | 0.74–1.16 | 0.53 |
| AMD | 2.15 | 1.90–2.43 | <0.0001 | 1.01 | 0.91–1.13 | 0.80 |
| Corneal disease | 2.71 | 2.16–3.40 | <0.0001 | 1.37 | 1.13–1.66 | 0.001 |
| DMR | 1.80 | 1.55–2.01 | <0.0001 | 1.11 | 1.00–1.28 | 0.13 |
| ERM | 1.95 | 1.64–2.32 | <0.0001 | 1.01 | 0.87–1.18 | 0.88 |
| Glaucoma | 1.22 | 1.12–1.33 | <0.0001 | 1.03 | 0.96–1.12 | 0.45 |
| Retinovitreal procedure | 3.88 | 1.78–8.46 | 0.0007 | 1.04 | 0.60–1.81 | 0.90 |
| PCR | 1.60 | 1.20–2.13 | 0.001 | 1.26 | 1.00–1.63 | 0.09 |
| Average time to refraction | ||||||
| 3–4 weeks | 1.00 | Ref. | 1.00 | Ref. | ||
| 5–7 weeks | 0.91 | 0.83–1.01 | 0.16 | 1.03 | 0.93–1.14 | 0.80 |
| 8+ weeks | 0.92 | 0.82–1.03 | 0.40 | 1.08 | 0.96–1.21 | 0.18 |
The logistic regression analyses were stratified on the identity of the surgeon and included every variable shown in the table, as coded in the table. RE and BCVA were obtained from manifest refraction using Snellen charts projected by standardized equipment (Nikon, Tokyo). Analysis of postoperative RE excluded patients with RE −2.1 or greater myopia. Emmetropia was defined as spherical error of −0.5 to 0 diopters (D), while eyes that were more myopic or hyperopic were defined as ametropic. Postoperative BCVA was obtained from the earliest measurement recorded nearest the date of surgery during the interval 3 weeks to 1 year after surgery. Tamsulosin dispensings were obtained from automated pharmacy data recorded up to 10 years before the first cataract surgery date. Preoperative medical conditions were obtained from diagnosis codes recorded into the electronic medical record.
Hypothesis 2: Adjusted* odds ratio (95% confidence interval) for the association of ISBCS vs DSBCS surgery with postoperative visual outcomes (within-patient average between the two eyes), Kaiser Permanente Northern California, 2013-June 2015.
Abbreviations: ISBCS Same-day bilateral cataract surgery; DSBCS different-day bilateral cataract surgery; BCVA best-corrected visual acuity; RE refractive error; IOL intraocular lens; D diopters; PCR post capsular rupture; AMD age-related macular degeneration; DMR diabetic macular retinopathy; ERM epiretinal membrane