UK pilot cataract surgery audit yields interesting findings

A large survey has recently been piloted in the UK to demonstrate the use and benefits of electronic data collection with respect to rapidly monitoring the access, delivery and outcome of cataract surgery in the UK's National Health Service (NHS) and to update benchmark standards for these parameters of care.

Eight NHS departments that currently use specialty-specific electronic clinical systems or Electronic Patient Records (EPR) to collect a minimum preoperative, operative and anaesthetic data set for cataract surgery agreed to pool their data. Here is a round-up of some of the most important top line results presented.

• An evaluation of the visual acuity threshold for cataract surgery found that it continues to fall in the UK and that the overall frequency of complications in modern surgery is low.

• Nuclear/epinuclear fragment loss into the vitreous was found to be an uncommon complication.
• Continuing collection of prospective data is feasible using the specialty-specific electronic clinical systems and could provide information useful to purchasers when planning healthcare priorities.

• The systems used in the study led to the development of the 'Cataract National Dataset', which will be able to evaluate the process, delivery and outcome of cataract surgery in the NHS.

• The survey demonstrated that electronic patient records (EPR) can ensure 100% operative data collection and update benchmark standards.

• The EPR enabled identification of preoperative risk factors for posterior capsule rupture and vitreous loss through analysis of a large dataset. High risk cases could be predicted and allow surgeons to take appropriate precautions.

• The study establishes a national benchmark for prediction error and demonstrated the potential of EPR to constantly monitor the quality of surgery in the NHS.

Ophthalmology Times Europe reporting from the XXIV Congress of the ESCRS, London, 9-13 September, 2006.