Cataract surgery at the Vancouver Eye Care Centre: Do patient indications meet provincial clinical practice guidelines?

Mildon, Drew; Noertjojo, Kukuh; Rollins, David F.; Blicker, Jeffrey; Law, Francis; Courtright, Paul; Bassett, Ken

doi:10.1016/s0008-4182(03)80061-3

Cited by 10 publications

(7 citation statements)

References 18 publications

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“…However, as described by Malik et al, 3 overuse of cataract surgery has been reported in many studies. [4][5][6][7][8][9][10] The thresholds for cataract surgery have become increasingly lenient 11,12 with a large number of patients undergoing cataract surgery with good vision. In patients with good vision, the need for surgery and potential benefits are dubious.…”

Section: Introductionmentioning

confidence: 99%

Cataract extraction and patient vision-related quality of life: a cohort study

Javed

McVeigh

Scott

et al. 2015

Eye

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Aims Cataract surgery is one of the most common surgeries performed, but its overuse has been reported. The threshold for cataract surgery has become increasingly lenient; therefore, the selection process and surgical need has been questioned. The aim of this study was to evaluate the changes associated with cataract surgery in patient-reported vision-related quality of life (VR-QoL). Methods A prospective cohort study was conducted. Consecutive patients referred to cataract clinics in an NHS unit in Scotland were identified. Those listed for surgery were invited to complete a validated questionnaire (TyPE) to measure VR-QoL pre-and postoperatively. TyPE has five different domains (near vision, distance vision, daytime driving, night-time driving, and glare) and a global score of vision. The influence of pre-operative visual acuity (VA) levels, vision, and lens status of the fellow eye on changes in VR-QoL were explored. Results A total of 320 listed patients were approached, of whom 36 were excluded. Among the 284 enrolled patients, 229 (81%) returned the questionnaire after surgery. Results revealed that the mean overall vision improved, as reported by patients. Improvements were also seen in all subdomains of the questionnaire. Conclusion The majority of patients appear to have improvement in patient-reported VR-QoL, including those with good preoperative VA and previous surgery to the fellow eye. VA thresholds may not capture the effects of the quality of life on patients. This information can assist clinicians to make more informed decisions when debating over the benefits of listing a patient for cataract extraction.

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Section: Introductionmentioning

confidence: 99%

Cataract extraction and patient vision-related quality of life: a cohort study

Javed

McVeigh

Scott

et al. 2015

Eye

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“…cases. 16 Tobacman et al 17 assessed the relationship between preoperative appropriateness of cataract surgery as rated by an expert panel against improvement in VA postoperatively. Appropriateness was rated by the RAND-UCLA method, based on objective measures from available literature and a mutual agreement between a panel of experts.…”

Section: Discussionmentioning

confidence: 99%

The Bristol cataract listing survey: Profile of listed patients with visual acuity 6/12 or better

Malik

Frost

Sparrow

et al. 2004

Eye

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Introduction The aim of this study was to assess the vision-related quality of life (VR-QOL) in patients with good distance Snellen visual acuity (VA) who are listed for cataract surgery. Methods An observational cross-sectional prospective study of patients listed for cataract surgery. VA and VR-QOL data using the VCMI questionnaire were collected on patients attending preoperative assessment during June 2002. Results A total of 397 cataract patients were listed during this month. Following exclusions there were 378 eligible individuals, 210 (56%) of whom had a VA of 6/12 or better in the eye scheduled for surgery. Of these, 40% patients had only mild VR-QOL impairment. More than half of the patients with good VA (6/12 or better) in the surgery eye and mild VR-QOL impairment described their vision as poor in this eye. However, most of these patients were not dissatisfied with their overall level of vision. Conclusion A significant number of patients listed for cataract surgery with VA of 6/12 or better had only mild VR-QOL impairment and were not dissatisfied with their overall level of vision. The decision to list a patient for surgery may have been based on the patient's perception of monocular vision rather than their quality of life.

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“…This older guarantee mainly used VA for setting priority and the evaluation concluded that VA alone did not represent sufficient prioritizing criteria. However, it is well known that in day-to-day practice poor VA is seen as the most common indication for surgery (Mildon et al 2003). During the initial phase of the project the participating teams reached an agreement about the items that should be included in the indication tool.…”

Section: Construction Of the Toolmentioning

confidence: 99%

NIKE: a new clinical tool for establishing levels of indications for cataract surgery

Lundström¹,

Albrecht²,

Håkansson

et al. 2006

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: The purpose of this study was to construct a new clinical tool for establishing levels of indications for cataract surgery, and to validate this tool. Methods: Teams from nine eye clinics reached an agreement about the need to develop a clinical tool for setting levels of indications for cataract surgery and about the items that should be included in the tool. The tool was to be called 'NIKE' (Nationell Indikationsmodell fo¨r Kataraktextraktion). The Canadian Cataract Priority Criteria Tool served as a model for the NIKE tool, which was modified for Swedish conditions. Items included in the tool were visual acuity of both eyes, patients' perceived difficulties in day-to-day life, cataract symptoms, the ability to live independently, and medical ⁄ ophthalmic reasons for surgery. The tool was validated and tested in 343 cataract surgery patients. Validity, stability and reliability were tested and the outcome of surgery was studied in relation to the indication setting. Results: Four indication groups (IGs) were suggested. The group with the greatest indications for surgery was named group 1 and that with the lowest, group 4. Validity was proved to be good. Surgery had the greatest impact on the group with the highest indications for surgery. Test-retest reliability test and interexaminer tests of indication settings showed statistically significant intraclass correlations (intraclass correlation coefficients [ICCs] 0.526 and 0.923, respectively). Conclusions: A new clinical tool for indication setting in cataract surgery is presented. This tool, the NIKE, takes into account both visual acuity and the patient's perceived problems in day-to-day life because of cataract. The tool seems to be stable and reliable and neutral towards different examiners.

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Cataract surgery at the Vancouver Eye Care Centre: Do patient indications meet provincial clinical practice guidelines?

Cited by 10 publications

References 18 publications

Cataract extraction and patient vision-related quality of life: a cohort study

Cataract extraction and patient vision-related quality of life: a cohort study

The Bristol cataract listing survey: Profile of listed patients with visual acuity 6/12 or better

NIKE: a new clinical tool for establishing levels of indications for cataract surgery

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