Cataract Surgical Rates in Latin America 2005-2011

João M. Furtado, Van C. Lansingh, María E. Nano, Marissa CarterVISION 2020 Latin America

PurposeTo describe the Cataract Surgical Rate (CSR) in 19 Latin

American countries from 2005 to 2011

Data obtained from National Societies of Ophthalmology, VISION 2020 Committees and Ministries of Health representatives

Latin AmericaPop: 563 million(* excluding the Caribbean; Source: United Nations)

Cataract is the main cause of blindness in the region (41-74%)

Furtado et al Surv Ophthalmol 2012

0

5

10

15

20

25

30

35

40

Argentina

Bolivia

Brazil

Chile

Colombia

Ecuador

Honduras

Mexico

ParaguayPeru

Uruguay

Venezuela

Perc

en

tag

e o

f P

op

ula

tion

≥

50

Years

Source: United Nations

Population ≥ 50 Years (2011)

Cataract Surgical Rate (CSR)Annual number of cataract operations performed per

million population

Lansingh et al Ophthalmic Epidemiol 2010

Country 2005 2006 2007 2008 2009 2010 2011Argentina 1769 2100 2089 2350 2650 2622 5515Bolivia 563 602 667 800 900 930 930Brazil 2448 2352 2212 2200 2400 2700 2904Chile 1751 1930 2132 2820 3200 3450 3950Colombia 1189 1350 1278 1350 1510 1590 1752Costa Rica 1400 2049 2144 2800 2950 3000 3200Cuba 1600 2219 3125 2324 2037 2428 2708Dominican Republic 710 682 779 900 1000 1247 1432

Ecuador 801 831 856 1050 1350 1490 1737El Salvador 1104 1151 1411 1050 1100 1150 1150

Guatemala 810 900 875 900 920 990 800Honduras 940 558 631 750 700 800 878Mexico 958 1200 1138 1300 1450 1550 1720Nicaragua 460 822 999 1300 1430 1610 1790Panama - 1180 1159 1197 1321 1693 1882Paraguay 800 895 957 1000 1100 1311 1351Peru 761 863 880 1429 1572 1400 1599Uruguay - 2000 1898 3933 4150 4419 4699Venezuela 960 1646 1754 2750 2950 3483 3650

CSR in Latin America

2005 2006 2007 2008 2009 2010 20110

1000

2000

3000

4000

5000

ArgentinaBrazilChile CubaGuatemalaMexicoParaguayPeruVenezuela

Year

CS

R

CSR in Latin America

2005 2006 2007 2008 2009 2010 20110

500

1000

1500

2000

2500

3000

Year

CS

R

1424

2513

CSR in Latin America

2005 2006 2007 2008 2009 2010 201110

30

50

70

90

110

130

150

ArgentinaBrazilChile CubaGuatemalaMexicoParaguayPeruVenezuela

Year

Nu

mb

er

of

Op

hth

alm

olo

gis

ts (

Pe

r M

il-li

on

Po

pu

lati

on

)Number of ophthalmologists

(per million population)

2005 2006 2007 2008 2009 2010 201125

27

29

31

33

35

37

39

41

43

45

Year

Nu

mb

er

of

Ca

tara

ct

Su

rge

rie

s

pe

r o

ph

tha

lmo

log

ist

30.4

41.6

Cataract Surgeries per ophthalmologist in Latin America

Why CSR is increasing in LA?Due to V2020 advocacy, more governments are

incorporating cataract surgery as a priority, providing surgeries free of charge

Strong partnership between ONGs and local foundations

PAHO 5-year plan influenced policy change in many countries

LimitationsLack of reliable data in some cases (especially private

sector)/Complete data is not available for all countries

CSR includes all cataract surgeries performed, so an improvement in CSR does not necessarily mean more blind people are receiving surgery

Discrepancies between different regions/districts of the same country are not shown by this method

Remaining challengesImprove data collection about number of surgeries performed

and outcome (also disaggregate by gender, level of VA)

Improve access to cataract surgery not only in countries with a low CSR, but also in rural areas from countries with a higher CSR

Ageing of the population will demand more cataract surgery in the near future

There’s no such an ‘target CSR’ that is good for every country

ConclusionCSR increased in 17 of 19 Latin American countries from

2005 to 2011, but cataract is still the main cause of blindness in the region

Indicator should help us to improve training and influence policy

CSR is a proxy indicator; we need to conduct population studies every 5 years to access quality of services and obtain CSC to determine if we are doing surgery in those with blindness/visual impairment

Acknowledgements