Changing practice patterns in European cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery 2008 to 2017

Mats Lundström, Mor Dickman, Ype Henry, Sonia Manning, Paul Rosen, Marie-José Tassignon, David Young, Anders Behndig, Ulf Stenevi, Mats Lundström, Mor Dickman, Ype Henry, Sonia Manning, Paul Rosen, Marie-José Tassignon, David Young, Anders Behndig, Ulf Stenevi

Abstract

Purpose: To study practice patterns in European cataract surgery over a 10-year period.

Setting: European clinics affiliated to the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO).

Design: Registry cohort study.

Methods: The EUREQUO contains preoperative, intraoperative, and postoperative parameters reported by surgeons in many European clinics. All data reported to the registry are anonymized. Preoperative parameters included age, sex, visual acuity, target refraction, ocular comorbidity, and surgical difficulties. Surgical data included anesthesia, surgical technique, intraocular lens optic biomaterial, and complications. Postoperative parameters included visual acuity, refraction, and short-term complications.

Results: During the study period (January 1, 2008, to December 31, 2017), a total of 2 714 108 cataract extractions were reported to the EUREQUO. Preoperative data changed over time, with decreases in mean age (74.5-73.0 years), proportion of women from 60.6% (100 373/165 628) to 57.2% (174 908/305 845), and proportion of coexisting eye diseases from 30.0% (49 638/165 650) to 27.0% (82 704/305 846) and with improvements in preoperative visual acuity (mean logarithm of minimum angle of resolution [logMAR] 0.46 to 0.37). The use of topical anesthesia increased over time from 28.1% (26 238/93 320) to 71.7% (130 525/182 083). Surgical complications showed a significant decrease from 2.5% (4107/165 650) to 1.2% (3573/305 846). The visual outcome improved over time (mean logMAR 0.08 to 0.05), as did the absolute median prediction error (0.38 diopter [D] to 0.28 D).

Conclusions: Trends in European cataract surgery practice patterns from 2008 to 2017 have moved toward younger patients with better preoperative visual acuity, fewer surgical complications, and better predicted refractions and visual outcomes.

Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of ASCRS and ESCRS.

References

    1. Liu YC, Wilkins M, Kim T, Malyugin B, Mehta JS. Cataracts. Lancet 2017;390:600–612
    1. Zetterberg M, Montan P, Kugelberg M, Nilsson I, Lundström M, Behndig A. Cataract surgery volumes and capsule complication rate per surgeon and clinical unit during a 10-year period—data from the Swedish National Cataract Register. Ophthalmology 2020;127:305–314
    1. Lundström M, Goh P-P, Henry Y, Salowi MA, Barry P, Manning S, Rosen P, Stenevi U. The changing pattern of cataract surgery indications—a five-year study of two cataract surgery databases. Ophthalmology 2015;122:31–38
    1. Lundström M, Barry P, Brocato L, Fitzpatrick C, Henry Y, Rosen P, Stenevi U. European registry for quality improvement in cataract surgery. Int J Health Care Qual Assur 2014;27:140–151
    1. Lundström M, Barry P, Henry Y, Rosen P, Stenevi U. Visual outcome of cataract surgery—a study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). J Cataract Refract Surg 2013;39:673–679
    1. Lundström M, Dickman M, Henry Y, Manning S, Rosen P, Tassignon MJ, Young D, Stenevi U. Risk factors for refractive error after cataract surgery—an analysis of 282 811 cataract extractions reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). J Cataract Refract Surg 2018;44:447–452
    1. Lundström M, Dickman M, Henry Y, Manning S, Rosen P, Tassignon MJ, Young D, Stenevi U. Risk factors for dropped nucleus in cataract surgery as reflected by the European Registry for Quality Outcomes in Cataract and Refractive Surgery (EUREQUO). J Cataract Refract Surg 2020;46:287–292
    1. Lundström M, Dickman M, Henry Y, Manning S, Rosen P, Tassignon MJ, Young D, Stenevi U. Femtosecond laser-assisted cataract surgeries (FLACS) reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO): baseline characteristics, surgical procedure, and outcomes. J Cataract Refract Surg 2017;43:1549–1556
    1. Nowak MS, Grabska-Liberek I, Michalska-Małecka K, Grzybowski A, Kozioł M, Niemczyk W, Więckowska B, Szaflik JP. Incidence and characteristics of cataract surgery in Poland, during 2010–2015. Int J Environ Res Public Health 2018;15:435
    1. Lundström M, Barry P, Leite H, Seward U, Stenevi U. 1998 European Cataract Outcome Study. Report from the European Cataract Outcome Study. J Cataract Refract Surg 2001;27:1176–1184
    1. Behndig A, Montan P, Stenevi U, Kugelberg M, Lundström M. One million cataract surgeries. The Swedish National Cataract Register 1992–2009. J Cataract Refract Surg 2011;37:1539–1545
    1. Lundström M, Stenevi U, Thorburn W. Gender and cataract surgery in Sweden 1992–1997. A retrospective observational study based on the Swedish National Cataract Register. Acta Ophthalmol Scand 1999;77:204–208
    1. Wai YZ, Chew FLM, Salowi MA, Ang CL, Chong YY, Adnan TH, Goh PP. The Malaysian cataract surgery register: incidence and risk factors of postoperative infectious endophthalmitis over a 7-year period. Int J Ophthalmol 2018;11:1685–1690
    1. Sommer A, Belkin A, Ofir S, Assia E. Profile of patients presenting for cataract surgery in a public hospital: a 15-year perspective. Isr Med Assoc J 2017;19:109–113
    1. Tee ES, Yap RWK. Type 2 diabetes mellitus in Malaysia: current trends and risk factors. Eur J Clin Nutr 2017;71:844–849
    1. Chung JK, Lee HK, Kim MK, Kim HK, Kim SW, Kim EC, Kim HS. Cataract surgery practices in the Republic of Korea: a survey of the Korean Society of Cataract and Refractive Surgery 2018. Korean J Ophthalmol 2019;33:451–457
    1. Pérez-Vives C, Biomaterial influence of intraocular performance. J Ophthalmol 2018;2018:2687385
    1. Lundström M, Behndig A, Kugelberg M, Montan P, Stenevi U, Thorburn W. Decreasing rate of capsule complication in cataract surgery in an 8-year perspective—a study of incidence, risk factors and data validity by the Swedish National Cataract Register. J Cataract Refract Surg 2011;37:1762–1767
    1. Lundström M, Barry P, Henry Y, Rosen P, Stenevi U. Visual outcome of cataract surgery—a study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). J Cataract Refract Surg 2013;39:673–679
    1. Henry Y. National Cataract Outcome register, 10 years results. Acta Ophthalmol 2018;96(suppl A260):33
    1. Lundström M, Frilling E, Montan P. Risk factors for endophthalmitis after cataract surgery—predictors for causative organisms and visual outcome. J Cataract Refract Surg 2015;41:2410–2416

Source: PubMed

3
Prenumerera