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Open Access Research article

Time series analysis of age related cataract hospitalizations and phacoemulsification

Alan M Leong1, Eric J Crighton1, Rahim Moineddin23, Muhammad Mamdani456 and Ross EG Upshur123*

Author Affiliations

1 Primary Care Research Unit, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Ave, #E-349, Toronto, ON, M4N 3M5, Canada

2 Department of Family and Community Medicine, University of Toronto, 256 McCaul Street, 2nd Floor, Toronto, ON, M5T 2W5, Canada

3 Department of Public Health Sciences, University of Toronto, McMurrich Building, 12 Queen's Park Crescent West, Toronto, ON, M5S 1A8, Canada

4 Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada

5 Health Policy Management and Evaluation, University of Toronto, McMurrich Building, 2nd Floor, 12 Queen's Park Crescent West, Toronto, ON, M5S 1A8, Canada

6 Faculty of Pharmacy, University of Toronto, 19 Russell Street, Toronto, ON, M5S 2S2, Canada

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BMC Ophthalmology 2006, 6:2  doi:10.1186/1471-2415-6-2

Published: 12 January 2006

Abstract

Background

Cataract surgery remains a commonly performed elective surgical procedure in the aging and the elderly. The purpose of this study was to utilize time series methodology to determine the temporal and seasonal variations and the strength of the seasonality in age-related (senile) cataract hospitalizations and phacoemulsification surgeries.

Methods

A retrospective, cross-sectional time series analysis was used to assess the presence and strength of seasonal and temporal patterns of age-related cataract hospitalizations and phacoemulsification surgeries from April 1, 1991 to March 31, 2002. Hospital admission rates for senile cataract (n = 70,281) and phacoemulsification (n = 556,431) were examined to determine monthly rates of hospitalization per 100,000 population. Time series methodology was then applied to the monthly aggregates.

Results

During the study period, age-related cataract hospitalizations in Ontario have declined from approximately 40 per 100,000 to only one per 100,000. Meanwhile, the use of phacoemulsification procedures has risen dramatically. The study found evidence of biannual peaks in both procedures during the spring and autumn months, and summer and winter troughs. Statistical analysis revealed significant overall seasonal patterns for both age-related cataract hospitalizations and phacoemulsifications (p < 0.01).

Conclusion

This study illustrates the decline in age-related cataract hospitalizations in Ontario resulting from the shift to outpatient phacoemulsification surgery, and demonstrates the presence of biannual peaks (a characteristic indicative of seasonality), in hospitalization and phacoemulsification during the spring and autumn throughout the study period.