The cataract national dataset electronic multicentre audit on clinical outcome following cataract surgery in patients aged 90 years and older

Session Details

Session Title: Cataract Surgery Practice Styles/PCO

Session Date/Time: Tuesday 10/10/2017 | 14:00-16:00

Paper Time: 14:00

Venue: Room 4.4

First Author: : S.Theodoropoulou UK

Co Author(s): :    J. Sparrow   R. Johnston   M. Grzeda   P. Donachie   D. Tole        

Abstract Details

Purpose:

The risk for complications associated with many surgical procedures is positively correlated with age, but surgical outcomes are negatively correlated with age. The number of very elderly patients waiting for cataract surgery is predicted to increase. At the present time, however, only a few reports of cataract surgery in patients older than 90 years have been published. Last year at ESCRS we presented the clinical outcome following cataract surgery in this age group of patients from the Bristol Eye Hospital and here we expand the analysis to a multi-centre sample.

Setting:

We report an analysis of data from 34 cataract surgery sites from the United Kingdom Royal College of Ophthalmologists' National Ophthalmology Database (NOD). Data on cataract surgery were recorded on the same electronic medical records system as part of routine cataract care.

Methods:

Outcome measures include the rates of ocular co-pathologies, the intraoperative complication rate for posterior capsule rupture or vitreous loss or both (PCR), and the preoperative and postoperative visual acuities (VA) in this group of elderly people.

Results:

Overall, 25,856 cataract operations were performed in 19,166 patients of 90 years or older between 2000 and 2015. Ocular co-pathology was present in 49% of eyes. PCR occurred in 2.7% eyes (100% ascertainment). Preoperative visual acuity was available for 82.4% eyes, of which VA was 0.30 LogMAR or better in 21.5%. Overall postoperative VA was available for 61.8% eyes. VA was 0.00 or better and 0.30 LogMAR or better in 15.1% and 74.4% of eyes, and for those without ocular co-pathology, postoperative VA was 0.00 or better and 0.30 LogMAR or better in 19.4% and 84.7% eyes respectively.

Conclusions:

Slightly poorer cataract surgery outcome results were noted in patients of 90 years or older, more so in patients with ocular co-morbidity which was highly prevalent. However, surgeons should not be deterred from offering cataract surgery to the very elderly as successful visual rehabilitation remains the norm.

Financial Disclosure:

NONE