Surgeon-Patient Sex Concordance and Postoperative Outcomes in Cataract Surgeries: A 16-Year Retrospective Cohort Study

Purpose: To determine if there is an association between surgeon-patient sex concordance and post-surgical complications for cataract surgeries. Patients and Methods: In this 16-year retrospective cohort study, data was collected from the Northwestern Medicine Electronic Data Warehouse on patients who underwent cataract surgery at Northwestern Memorial Hospital in Chicago, IL. The self-identified sex of the surgeon and patient was recorded for each surgery. Peri-operative complications and associated procedures that occurred within 30 days of surgery as marked by diagnosis codes, billing codes, or post-operative notes were recorded. Peri-operative complications included one or more of endophthalmitis, choroidal hemorrhage, posterior capsular tear, retinal detachment, vitreous loss, retained lens fragments, or return to operating room for vitrectomy within 30 days. The primary outcome was the association between the presence of any postoperative complications from cataract surgery and surgeon-patient sex discordance. Results: From 2007 to 2023, 30,804 cataract surgeries were performed on 19,178 unique patients. About 47.69% were sex concordant procedures and 51.00% were sex discordant. A post-operative or intra-operative complication occurred in 3.5% of patients. Among cataract surgeries that resulted in one or more complications, 50.3% were sex-concordant while 49.7% were sex-discordant. The most common post-operative complication experienced among individuals with complications was retinal detachment. Conclusion: The results of our study demonstrate no significant association between surgical complication rates and surgeon-patient sex discordance following cataract surgery, supporting comparable outcomes irrespective of surgeon-patient sex concordance. Plain Language Summary: Previous research may suggest that when a doctor and patient are of the same sex, health outcomes can improve, though the reasons for this are not fully evidence based. Our research team aimed to investigate if this applied to cataract surgery, one of the most commonly performed surgeries in the world. The team analyzed over 30,000 cataract surgeries performed in Chicago, IL, USA between 2007 and 2023. Researchers recorded whether each surgeon and patient were of the same sex and tracked complications such as retinal detachment or infection that occurred within 30 days of surgery. Complications occurred in 3.5% of cases overall. When the researchers compared sex-concordant and sex-discordant surgeon-patient pairings, no meaningful difference in complication rates between the two groups was found. The results of this study suggest that patients can be reassured that the sex of their cataract surgeon does not affect their safety or surgical outcome. Subsequent research should explore whether the same holds true across other eye surgeries and non-surgical care settings, as these findings could shape training standards for future surgeons.