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Research Article: Comparative analysis of cataract surgery outcomes in elderly Jewish and Arab patients from Northern Israel, a retrospective cohort study

Date Published: 2026-09-24

Abstract:
To compare postoperative visual recovery and complications after cataract surgery between Jewish and Arab elderly patients in Northern Israel within a shared healthcare system. A retrospective study was conducted at Ziv Medical Center, Safed, Israel, involving 251 patients aged 60 years or older who underwent cataract surgery in 2023. All surgeries were performed under standardized departmental protocols, carried out by senior attending surgeons or supervised senior residents. Demographic characteristics, comorbidities, cataract type, postoperative complications and best-corrected visual acuity (BCVA) were extracted from electronic medical records. Visual outcomes were compared at baseline, day 1, and day 30 postoperatively. All statistical analyses were performed using IBM SPSS Statistics version 31, with continuous variables compared via Mann-Whitney U test and categorical variables via chi-square or Fisher’s exact test, as appropriate. Baseline age, sex, and preoperative visual acuity were similar between Jewish (n=153) and Arab (n=98) patients. Of the 153 Jewish patients, 77 (50.3%) were male and 76 (49.7%) were female. Of the 98 Arab patients, 49 (50.0%) were male and 49 (50.0%) were female (p = 0.960). Arab patients had higher rates of diabetes (54.1% vs. 35.9%, p=0.005) and hypertension (70.4% vs. 58.2%, p=0.050). Jewish patients demonstrated significantly better postoperative BCVA at 30 days (median LogMAR 0.5 vs. 0.7, p=0.0032). Complications were more common in the Arab cohort, particularly corneal edema (43.9% vs. 15.7%, p<0.001) and posterior capsule rupture (11.2% vs. 3.3%, p=0.012). Ethnic disparities were observed in short-term outcomes despite a uniform surgical environment within the same tertiary facility. These differences are more plausibly explained by structural, socioeconomic, and comorbidity-related determinants than by any biological difference associated with ethnicity per se. Further multicenter, prospective studies with longer follow-up are required to clarify the multifactorial causes of outcome variation and guide interventions to promote equity in cataract care.

Introduction:
Cataract, defined as partial or complete clouding of the eye’s normally transparent lens or its capsule, is the leading cause of reversible visual impairment in the elderly worldwide ( 1 , 2 ). While initially slow to progress, cataracts tend to worsen with age, particularly after the fourth or fifth decade, ultimately interfering with daily functioning ( 3 ). Nearly half of individuals in their early 70s and almost all in their 90s develop clinically significant cataracts. The National Eye Institute estimates…

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