European observatory of cataract practice: intracameral mydriatics and anesthetics in cataract surgery in 2015 in Sweden compared to EU

Session Details

Session Title: Cataract Surgery Instrumentation/Surgical Devices

Session Date/Time: Sunday 11/09/2016 | 10:30-12:00

Paper Time: 10:30

Venue: Hall C1

First Author: : U.Pleyer GERMANY

Co Author(s): :                        

Abstract Details

Purpose:

A sufficient and stable mydriasis is a prerequisite during phacoemulsification to allow visualization of the capsulorhexis and lens and in intraocular lens implantation. Adequate ocular anesthesia facilitates patient cooperation, and reduces the risk of intraoperative complications. The main objective of the current survey is to understand and assess therapeutic protocols and clinical practices regarding mydriasis in cataract surgery. This abstract is focused on the results of the Sweden where intracameral mydriatics and anesthetic combinations are widely used in cataract surgery

Setting:

In this 3rd wave of an EU survey conducted among cataract surgeons in Belgium, France, Germany, Italy, the Netherlands, Poland, Spain, Sweden and the UK in 2015, 480 surgeons were recruited for the survey, among which 20 surgeons were from Sweden.

Methods:

For inclusion, cataract surgeons needed to have at least 5 years of practice and to undertake at least 150 cataract procedures yearly. Surgeons were included pro rata depending on the number of cataract surgeons in each country. The 40 item questionnaire was divided into nine categories; screening, surgeon profile, surgical procedure, therapeutic strategies, product use before arrival at the operating room (OR), techniques for mydriasis and anesthesia, product use in the OR, product use after leaving the OR and surgeons’ attitude to guidelines. This abstract compares the results from Sweden with the global results from all other countries studied.

Results:

The average number of yearly cataract surgeries per surgeon was 530. In total > 250.000 cataract surgeries were performed whereof > 15.000 in Sweden. Many parameters differed between Sweden and the global results. The use of intracameral mydriatics was significantly higher in Sweden, 62% vs. 19%; p<0.005. Dilation problems leading to delay of surgery were lower in Sweden, 2.4% vs. 7.2%, with a delay duration of about 8 minutes vs. 12.8 minutes. Intracameral anesthetics usage was higher in Sweden, 73% vs. 21%; p<0.005. Accordingly, the rate of patients perceiving insufficient pain control was lower in Sweden: 2.7% vs. 6.9% during surgery and 0.9% vs. 5.8% postoperatively.

Conclusions:

The results of the 3rd wave of the European Observatory in Cataract Surgery related to mydriasis practices highlighted that intracameral injection of mydriatics and anesthetics is widely practiced in Sweden, as opposed to in the rest of the EU. Interestingly, we observed less dilation problems leading to delay in cataract surgeries in Sweden, and in addition, the lowest rates of patients complaining of insufficient pain control during cataract surgery were also seen in Sweden. We conclude that these differences in favor of Sweden may be related to the more widespread use of intracameral mydriatics and anesthetics.

Financial Disclosure:

NONE