Ophthalmology Research - Eye Surgery, Myopia, Cataracts

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Benchmark standards for refractive outcomes after NHS cataract surgery.

Gale RP, Saldana M, Johnston RL, Zuberbuhler B, McKibbin M

1Department of Ophthalmology, The Leeds Teaching Hospital NHS Trust, Leeds, West Yorkshire, UK.

PurposeTo establish benchmark standards for refractive outcome after cataract surgery in the National Health Service when implementing the 2004 biometry guidelines of the Royal College of Ophthalmologists and customising Aconstants.MethodsThree cycles of prospective data were collected throughout the cataract care pathway on all patients using an electronic medical record system (Medisoft Ophthalmology), between January 2003 and February 2006. The electronic medical record automatically recommends the formula to be used according to the College guidelines and allows Aconstants to be customised separately for either ultrasound or partial coherence interferometry methods of axial length measurement and for different intraocular lens models. Consultants and trainees performed routine phacoemulsification cataract surgery and new intraocular lens models were introduced during the cycles. Uncomplicated cases with'in-the-bag fixation', achieving 6/12 Snellen acuity or better were included. Community ophthalmic opticians performed refraction at 4 weeks.ResultsThe postoperative subjective refraction was within 1 D of the predicted value in 79.7% of the 952 cases in cycle 1, 83.4% of 2406 cases in cycle 2, and 87.0% of 1448 cases in cycle 3.ConclusionsOn the basis of our data, using College formula, optimising Aconstants and partial coherence interferometry, a benchmark standard of 85% of patients achieving a final spherical equivalent within 1 D of the predicted figure and 55% of patients within 0.5 D should be adopted.Eye advance online publication, 24 August 2007; doi:10.1038/sj.eye.6702954.

Published 27 August 2007 in Eye.
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Ophthalmology Research Today Archive:

Volume 1 (2005)
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  Issue 2 (December)

Volume 2 (2006)
  Issue 1 (January)
  Issue 2 (February)
  Issue 3 (March)
  Issue 4 (April)
  Issue 5 (May)
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Volume 3 (2007)
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  Issue 4 (April)
  Issue 5 (May)
  Issue 6 (June)
  Issue 7 (July)
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  Issue 10 (October)
  Issue 11 (November)
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Volume 4 (2008)
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  Issue 4 (April)
  Issue 5 (May)
  Issue 6 (June)
  Issue 7 (July)
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Ophthalmology Books

Walsh & Hoyt's Clinical Neuro-Ophthalmology: The Essentials (Walsh & Hoyt's Clinical Neuro-Ophthalmology)

Walsh & Hoyt's Clinical Neuro-Ophthalmology: The Essentials (Walsh & Hoyt's Clinical Neuro-Ophthalmology)