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

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.

Efficacy of Preoperative Music Intervention on Pain and Anxiety in Patients Undergoing Cataract Surgery

“…Cataract surgery represents one of the most commonly performed procedures in the world ( Pascolini and Mariotti, 2012 ). Advancements in anesthesia and surgical techniques made it possible to perform most of the procedures for cataract extraction under topical anesthesia ( Pellegrini et al, 2020 ; Lundström et al, 2021 ). On the one hand, this achievement has greatly reduced operating times and side effects related with local or general anesthesia ( Giannaccare et al, 2021 ; Lundström et al, 2021 ).…”

Refractive Outcomes after Cataract Surgery

“…The impact of optical biometry on refractive outcomes after cataract surgery can be appreciated by observing the steadily increasing percentage of patients achieving within ±1.0 D or ±0.5 D of their target refraction in studies between 1992 and 2017 [ 10 , 11 , 20 , 21 , 22 , 23 , 24 ]. Between 1992 and 2006, studies showed that 72.3–87.0% of patients achieved a deviation from the target refraction of ±1.0 D [ 10 , 11 , 20 , 21 ], which increased to 89.6–97.3% between 2007 and 2017 [ 22 , 23 , 24 ].…”

Corneal Analysis with Swept Source Optical Coherence Tomography in Patients with Coexisting Cataract and Fuchs Endothelial Corneal Dystrophy

“…The National Eye Institute has established that the risk of cataracts increases with each decade of life, starting around the age of 40. Phacoemulsification with intraocular lens implantation surgery has been proven to be safe, with very few surgical complications, and very effective in terms of the predictability of refraction and visual outcomes [2,3]. However, optimal precision in the refractive outcome in cataract surgery depends on a precise preoperative assessment and attention to pre-existing ocular comorbidities [2][3][4].…”

“…Phacoemulsification with intraocular lens implantation surgery has been proven to be safe, with very few surgical complications, and very effective in terms of the predictability of refraction and visual outcomes [2,3]. However, optimal precision in the refractive outcome in cataract surgery depends on a precise preoperative assessment and attention to pre-existing ocular comorbidities [2][3][4]. The proportion of coexisting ocular comorbidities according to the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) is high and ranges from 27 to 30% and should be taken into consideration while qualifying patients for cataract surgery [2].…”