Operation volumes and posterior capsule rupture per surgeon and clinical unit during a 10 year period: data from the Swedish National Cataract Register

Session Details

Session Title: Training & Surgical Practice

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

Paper Time: 17:48

Venue: Room A2

First Author: : M.Zetterberg SWEDEN

Co Author(s): :    A. Behndig                    

Abstract Details

Purpose:

To investigate the change in cataract surgeons' operation volume over time and to determine the risk of posterior capsule rupture in relation to volume. In addition, the effect of operation volume per surgical unit was determined in relation to time and complication rate.

Setting:

National register-based study

Methods:

Data was retrieved from the national register on all cataract operations performed between 2007 and 2016 in Sweden. The number of cataract procedures performed per surgeon and clinic was noted as well as rate of posterior capsule rupture (PCR) and type of clinical setting (private, public).

Results:

The proportion of high-volume surgeons (≥500 procedures/year) increased from 14.2% 2007 to 32.6% 2016 (p<0.001); surgeons with ≥1000 procedures/year increased from 2.0% to 10.5% (p<0.001,Chi2-test). In 2007, 36.9% of all procedures were performed by high-volume surgeons compared to 68.1% in 2016 (p<0.001,Chi2-test). In 2007, 14.7% of cataract surgeons worked in the private sector; in 2016 the number was 36.7%. Low-volume surgeons (<100 procedures/year) had a PCR rate of 4.26±14.5%; for high-volume surgeons (≥500 procedures/year) mean incidence was ≤0.59%. Clinical units performing <1000 operations/year had a PCR rate of 0.91±0.86% and units with >2000 surgeries/year had a PCR rate of 0.85±0.70%;p=0.690).

Conclusions:

The incidence of PCR correlated strongly with operation volume per surgeon but not per clinical unit. The increase in the proportion of high-volume cataract surgeons will lead to a continued decrease in complication rates.

Financial Disclosure:

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