Determination of Valid Benchmarks for Outcome Indicators in Cataract Surgery

Benchmarks for outcome indicators in pediatric cataract surgery

“…Furthermore, due to the continued growth of the eye and changing refractive status, a smaller window is needed to obtain the post-operative refraction and assess PE, and the final refractive status and vision may not be known for many years. PE was greater in our population compared with that reported in adult studies, 1,4,6 likely due to measurement error in these small compliant eyes or lack of customized constants for IOL formula calculations. The children with bilateral cataract surgery in our study achieved excellent VA outcomes, which is comparable to outcomes reported for surgery in adult eyes.…”

“…[1][2][3][4][5][6][7] To evaluate performance, a reference for good quality or best practice is needed, the so-called benchmark. It is increasingly important to establish benchmarks in the face of initiatives by the government, hospitals, and insurance companies to improve quality of care and effectiveness.…”

“…It is increasingly important to establish benchmarks in the face of initiatives by the government, hospitals, and insurance companies to improve quality of care and effectiveness. 1 Pediatric patients often represent 'complicated' cases as the surgery can be technically challenging compared with the adult cataract surgery owing to highly elastic lens capsule, low scleral rigidity, small compliant eyes, and the need for primary management of posterior capsule and anterior vitreous due to higher incidence of visual axis opacification. In addition, despite the best technical outcomes, functional vision outcomes can be less reliable not only due to variable cooperation for vision testing, but VA measures can be compromised by co-existing conditions such as amblyopia, latent nystagmus, strabismus, or intentionally planned residual refractive error, which must be managed concurrently in a young child.…”

“…It is important to adopt indicators that unify and simplify often complex medical interventions to create a common base for comparing the performance and the outcome of different providers. 1 The most commonly used indicators in adult cataract surgery are best corrected visual acuity (BCVA) and refractive accuracy as reported in multiple benchmark studies. [1][2][3][4][5][6][7] However, there are no publications focused on benchmark indicators in pediatric cataract surgery, probably because pediatric patient populations usually include 'complicated' cases, with unique surgical and management challenges, including inability to obtain accurate biometry or cooperate for reliable visual acuity (VA) testing.…”

“…1 The most commonly used indicators in adult cataract surgery are best corrected visual acuity (BCVA) and refractive accuracy as reported in multiple benchmark studies. [1][2][3][4][5][6][7] However, there are no publications focused on benchmark indicators in pediatric cataract surgery, probably because pediatric patient populations usually include 'complicated' cases, with unique surgical and management challenges, including inability to obtain accurate biometry or cooperate for reliable visual acuity (VA) testing. Young children have smaller eyes with shorter globe axial length (AL), and potentially anterior segment anatomic abnormalities that can affect effective biometry measures, intraocular lens (IOL) calculations, and effective IOL position and thus post-operative refraction.…”