Going paperless: improved cataract surgery outcome data quality in a new fully electronic unit

Session Details

Session Title: Training & Surgical Practice

Session Date/Time: Tuesday 25/09/2018 | 16:00-18:00

Paper Time: 17:18

Venue: Room A2

First Author: : A.Nghiem UK

Co Author(s): :    C. Canning   J. Eason   J. Sparrow   T. Flynn           

Abstract Details

Purpose:

To report outcome data on the first 5000 consecutive cataract cases at a new paperless eye unit and benchmark against the Royal College of Ophthalmologists’ National Ophthalmology database (NOD). To benchmark our cataract surgery results against the NOD results using the NOD definition of post-operative visual acuity in order to assess the representativeness of our data. To investigate whether including data from patients seen and discharged within 2 weeks of surgery made a material difference to the visual outcomes. To report outcomes on this more inclusive and almost complete dataset of 5008 consecutive cases

Setting:

Moorfields Eye Centre at Croydon University Hospital

Methods:

Using the in-built audit tool of the electronic medical records system, data from all cataract operations performed between 1st April 2014 to 10th January 2017 were compiled. These dates represent the opening date of the new eye unit and the date at which the 5000th cataract operation was performed. Baseline data on demographics, pre-operative VA, ocular co-morbidities and whether the surgery was on a first or second eye were collected. Outcome data on intra-operative complications, post-operative complications and post-operative VA were collected.

Results:

5008 cases were recorded of which the overall intra-operative complication rate was 2.4%. The NOD uses the definition of posterior capsular ruptue (PCR) to include PCR with and without vitreous loss and zonular rupture with vitreous loss; by this definition the PCR rate was 1.14%. Follow-up data on post-operative complications were recorded in 98.6% of cases. Pre-operative visual acuity and post-operative visual acuity was measured in 98% of cases. 40.8% of eyes achieved a visual acuity of 6/6 or better and 90.7% achieved 6/12 or better.

Conclusions:

A near complete dataset of over 5000 cataracts operations was obtained in this new eye department. This compares to RCOphth NOD Audit Report 2017 where pre-operative visual acuity and post-operative visual acuity were recorded in only 57.1% of operations. Despite this difference, the outcome measures from this unit and RCOphth NOD were very similar possibly validating the results of the NOD audit reports. Significantly, when applying the RCOphth NOD audit criteria for measuring post operative visual acuity, approximately 15% of cases were excluded from the dataset; reducing the completeness of the dataset.

Financial Disclosure:

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