Cataract surgery outcomes in Patients with English as a first language versus English as a second language

Background: Language barriers may impact surgery outcomes by affecting patient understanding, adherence, and communication, yet their role in ophthalmic procedures remains understudied. Aim: To evaluate the impact of language barriers on cataract surgery outcomes, focusing on complications and visual acuity (VA). Setting: A single-center cohort study at a tertiary referral hospital in Washington, DC, USA. Design: Retrospective analysis of cataract surgery patients divided into two groups: patients with English as a second language (ESL) and primary English speakers. Materials and Methods: The outcomes measured in the two groups included capsular complications, postoperative endophthalmitis, uncorrected VA ≥20/40 at 1 month, and pupil expansion device usage. The exclusion criteria included general anesthesia, significant corneal/retinal pathology, and concurrent surgical procedures beyond standard phacoemulsification and intraocular lens implantation. Results: The study included 165 patients, with 31 in the ESL group and 134 in the non-ESL group. While capsular complication rates were similar between the groups, ESL patients showed higher rates of postoperative endophthalmitis (3.20% vs. 0%, P = 0.037), lower achievement of uncorrected VA ≥20/40 at 1 month (67.7% vs. 83.6%, P = 0.044), and increased need for pupil expansion devices (9.70% vs. 0.70%, P = 0.004). Other complications showed no significant differences. Conclusions: Despite similar rates of capsular complications, ESL patients undergoing cataract surgery may require increased perioperative attention due to a higher risk of postoperative endophthalmitis and poorer visual outcomes. Tailored interventions and further research are necessary to improve the outcomes for ESL patients in cataract surgery.