A system for preoperative stratification of cataract patients according to risk of intraoperative complications: a prospective analysis of 1441 cases

Muhtaseb, Mohammed; Kalhoro, Aurangzeb; Ionides, Alexander

doi:10.1136/bjo.2004.046003

Cited by 122 publications

(118 citation statements)

References 11 publications

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“…3 For post-CCST surgeons, we should expect a lower rate of posterior capsular tears and zonular dehiscence than Brown's syndrome is a rare but serious complication of cosmetic blepharoplasty.…”

Section: Case Reportmentioning

confidence: 99%

To assess the results of the clinical outcome of high volume cataract operations performed by a fellow and a consultant in Moorfields Eye Hospital

Girgis

Salam

Verma

2012

Eye

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Section: Case Reportmentioning

confidence: 99%

To assess the results of the clinical outcome of high volume cataract operations performed by a fellow and a consultant in Moorfields Eye Hospital

Girgis

Salam

Verma

2012

Eye

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“…14,15 Two studies have published scoring systems to help stratify preoperative risk factors for cataract surgery. 16,17 Both, however, were derived from information in previous literature comparing potential risk features with perioperative complications. One study, in addition, took into account consultant surgeons' subjective opinions about factors that were associated with increased complications.…”

mentioning

confidence: 99%

The Cataract National Dataset electronic multicentre audit of 55 567 operations: risk stratification for posterior capsule rupture and vitreous loss

Narendran

Jaycock

Johnston

et al. 2008

Eye

253

230

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Aims To identify and quantify risk factors for posterior capsule rupture or vitreous loss or both (PCR or VL or both) during cataract surgery and provide a method of composite risk assessment for individual operations. Methods The Cataract National Dataset was extracted on 55 567 operations from 12 National Health Service (NHS) Trusts using an electronic patient record (EPR) system between November 2001 and July 2006. Risk indicators for variations in the rate of 'PCR or VL or both' were identified by univariate and multivariate analyses. Adjusted odds ratios (ORs) were used to formulate a composite 'bespoke' risk for individual cases. Results Overall 'PCR or VL or both' rate was 1.92% (95% CI ¼ 1.81-2.04%). Risk indicators for this complication were increasing age, male gender, presence of glaucoma, diabetic retinopathy, brunescent/white cataract, no fundal view/vitreous opacities, pseudoexfoliation/phacodonesis, reducing pupil size, axial length X26.0 mm, the use of the ablocker doxazosin, inability to lie flat and trainee surgeons performing operations. Adjusted ORs for these variables are used to estimate overall composite risk across multiple risk indicators in the form of a predicted probability of PCR or VL or both. Predicted probability for this complication ranged from less than 0.75% to more than 75%, depending on risk profile of individual operations. Conclusions Higher-risk cases can be predicted, thus better informing the consent process and allowing surgeons to take appropriate precautions. Case-mix is a major determinant of the probability of an intraoperative complication. A simple composite risk estimation system has been developed.

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“…[1][2][3][4][5][6][7] This is a triad of billowing of iris stroma with intraocular fluid currents, iris prolapse through corneal wounds, and intraoperative progressive pupil constriction. 1 While tamsulosin (Flomax TM ) has been associated with the highest rate of IFIS, other alpha-1 antagonists have also been implicated.…”

Section: Alpha Antagonists and Intraoperative Floppy Iris Syndrome (Imentioning

confidence: 99%

“…This may lead to misinformation of patients. Further, preoperative risk stratification 4 was not carried out and visual outcome not considered as the performance outcome.…”

mentioning

confidence: 99%

Deciphering the code: does clinical coding accurately reflect peroperative cataract surgery complication rates?

Jain

Thampy

Suharwardy

2006

Eye

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A system for preoperative stratification of cataract patients according to risk of intraoperative complications: a prospective analysis of 1441 cases

Cited by 122 publications

References 11 publications

To assess the results of the clinical outcome of high volume cataract operations performed by a fellow and a consultant in Moorfields Eye Hospital

To assess the results of the clinical outcome of high volume cataract operations performed by a fellow and a consultant in Moorfields Eye Hospital

The Cataract National Dataset electronic multicentre audit of 55 567 operations: risk stratification for posterior capsule rupture and vitreous loss

Deciphering the code: does clinical coding accurately reflect peroperative cataract surgery complication rates?

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