A proposed minimum set of outcome measures for cataract surgery

Session Details

Session Title: Cataract Surgery Practice Styles

Session Date/Time: Wednesday 17/09/2014 | 08:00-09:30

Paper Time: 08:32

Venue: Boulevard B

First Author: : I.Mahmud USA

Co Author(s): :    M. Lundström   T. Kelley   C. Stowell        

Abstract Details

Purpose:

To propose a minimum set of outcome measures for cataract surgery suitable for global comparisons

Setting:

Any clinic world-wide performing cataract surgery

Methods:

A working group of leading experts in the fields of cataract surgery and outcome measurements was convened. Working group members were drawn from several countries including Australia, India, Malaysia, Sweden, the United Kingdom and the United States, with professional backgrounds encompassing ophthalmology and optometry and significant experience in registry development. A research fellow was recruited to help with the process of collecting and compiling the outcomes of the working group. In addition, a patient advocate was recruited to the project. Over a period of 12 months, the working group met every four to six weeks by teleconference to discuss outcomes for inclusion in the Standard Set. Discussions also included how and when the outcomes should be gathered, and their subsequent reporting formats. In a process similar to that used to compile the minimum set of outcomes, a series of consensus discussions were held to determine a set of risk factors that would be gathered for each patient, including baseline clinical factors, patient demographics, ocular history and technical factors related to surgical complications and vision outcomes. The final shortlist was compiled into a Standard Set.

Results:

Eligible patients are all those treated for symptomatic cataract, by one of four surgical approaches (phacoemulsification, sutured manual extra-capsular cataract extraction, suture-less manual extra-capsular cataract extraction, intra-capsular cataract extraction). Data should be stratified according to surgical technique. Risk factors including demographic data, patient ocular history and comorbidities, pre-operative visual acuity and patient-reported visual function will be gathered prior to surgery when patients are reviewed in clinic and cataract surgery is planned. Visual acuity, visual function, and intended surgical refraction were included to inform accurate postoperative assessment. Patient-specific technical or anatomical/pathological factors with potential to complicate surgery should be recorded prior to or at the end of the operation. In addition, complications of surgery should be recorded at the end of the operation. The suggested follow-up period for collection of post-operative outcomes is up to three months. Measures include not only objective outcomes such as clinical complications, visual acuity, and refraction, but also subjective visual function obtained using patient-reported outcome measures.

Conclusions:

A Standard Set of metrics in order to measure outcomes of cataract surgery was proposed. Measures included in the Standard Set reflect the need for meaningful and pragmatic data collection that can be incorporated into existing patient pathways in a variety of clinical contexts. Of necessity, the resultant dataset is therefore a compromise between all that is useful for comparison and the practicalities of data collection.

Financial Interest:

NONE