Cataract Surgical Outcomes: A Five-Year Audit
Linda Santamaria DipAppSc(Orth) MAppSc
Christine Chen PhD FRANZCO
Marcel Favilla MBBS BMedSc MBA FRANZCO
Ophthalmology Department, Monash Health, Melbourne, Australia
Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Australia
Aim: Cataract extraction with intraocular lens implantation is the most common elective procedure in Australia. In order to ensure best clinical practice, outcome results must be compared with nationally or internationally accepted benchmarks. The aim of this paper was to present the clinical outcomes audit for a five-year period from 2008 to 2012 and compare to these benchmarks.
Method: A random sample of 1,734 patients was selected over a five-year period. Preoperative, surgical and postoperative data was recorded, including best-corrected visual acuity (BCVA), refraction and the VF-14 visual function questionnaire.
Results: In 2012, the mean final BCVA was 6/7 (0.87 decimal, 95%CI 0.84 0.90) significantly increased from 6/15 preoperatively (0.41 decimal, 95%CI 0.39 0.43, p<0.001), with 97% achieving 6/12 (0.50 decimal) or better and 52% achieving 6/6 (1.0 decimal) or better, with no significant differences over the five-year period. The mean refractive prediction error varied from -0.03 to -0.13 dioptres (DS), with 89 to 94% achieving a refractive prediction error within ±1.00 DS and 64 to 75% within ±0.50 DS. The VF- 14 visual function postoperative mean for 2012 was 84.90 (95%CI 82.25 87.54) significantly increased from 70.34 preoperatively (95%CI 67.89 72.79, p<0.001), similar over the five-year period. Conclusions: The Monash Health clinical outcomes of both visual acuity and refraction were within recommended benchmarks. With increasing pressure on the public health system an efficient and cost-effective service with the highest level of care is essential. A continual auditing process assesses this care and ensures the maintenance of quality outcomes.
Keywords: cataract outcomes, cataract audit, refractive outcomes