Posters

Surgical cataract process and topical medication in the biggest tertiary eye hospital in Finland during 2015–2018

Poster Details

First Author: S.Loukovaara FINLAND

Co Author(s):    V. Lehtinen   R. Nieminen   J. Moilanen              

Abstract Details

Purpose:

Cataract surgery (CS) is the most common surgical procedure in the world. Topical medication used in CS varies worldwide, being specific to each surgical unit. We explored the full surgical cataract care process/pathway, taking into account the rate of intraoperative complications, the need of potential additional measures i.e. insertion of Malyugin Ring and/or hooks, and actual topical treatment in a large adult population cohort.

Setting:

Retrospective observational BCB Medical register-based cohort analysis of 19,994 patients, including 21,962 eyes operated by multiple surgeons in a university eye hospital, in Helsinki, Finland, from January 1, 2015 to December 31, 2018, covering 4 years.

Methods:

The surgical technique was the standard minimally invasive phacoemulsification technique (Infinity/Centurion Vision System, Alcon Laboratories, Inc., Fort Worth, TX, USA) with a 2.4-2.75 mm clear corneal incision, and insertion of intraocular lens (IOL). To prevent postoperative endophthalmitis antibiotic injection to the anterior chamber was performed using cefuroxime 10mg/ml (0.1 ml) or vancomycin 10mg/ml (0.1 ml) systematically at the end of surgery. As topical treatment, operated eyes were treated with levofloxacin 5mg/ml, prednisolone acetate (PA)10mg/ml (1%) and/or non-steroidal anti-inflammatory drug (NSAIDS) nepafenac 3%.

Results:

37.8% of the operated eyes had normal, 41.2% moderate, and 6.0% advanced cataract. Complications occurred in 1.8% of the eyes. Majority of eyes received intracameral ab injection. Topical treatment was levofloxacin and nepafenac in 60.8%; levofloxacin and PA in 20.3%, and 7.8% received triple combination i.e. levofloxacin, PA, and nepafenac. Noteworthy, topical PA was used in the most advanced cataract eyes (28.6%), and in the eyes with preoperative visual acuity < 0.1 (25.2%), and in the eyes with intraoperative complication: anterior capsule tear (42.5%), iris damage (47.5%), rupture of posterior capsule (48.2%), and dropped nucleus (56.3%).

Conclusions:

In Finland, structural database tools, originally developed for hospital administrative purposes, can be valued and the accumulated structural data can be analysed to increase understanding of the surgical care implementation as a whole, aiming to improve the quality of surgical process and understanding the treatment regimen, especially in high-volume surgical units.

Financial Disclosure:

None