Going paperless: improved cataract surgery outcome data quality in a new fully electronic unit

Nghiem, Allan Zhifa; Canning, C R; Eason, James D.; Sparrow, J M; Flynn, Tom

doi:10.1038/s41433-019-0350-1

Cited by 4 publications

(6 citation statements)

References 3 publications

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“…Postoperative uveitis developed in our study in 1.4% of eyes, postsurgical macular edema in 1.6% of eyes, and retinal detachment in 0.11% of eyes. Once again, these results are similar to rates previously reported of 1.53%-2.6% for uveitis [9,10], 0.03%-2% for macular edema [9,10,18], and 0.14-0.21% for retinal detachment [9,11,19,20].…”

Section: Discussionsupporting

confidence: 92%

“…Patients included in our study were slightly younger, mean of 70.42 years, than those included in the 2013 (mean 73.9 years) and 2018 (mean 73.5 years) EUREQUO reports [6,7], with a majority of women. e percentage of eyes with prior pathologies and preoperative conditions increasing the surgical complexity (28.55% and 11.1% respectively) was similar in our study to those in the previous reports [6,9,10].…”

Section: Discussionsupporting

confidence: 91%

“…Intrasurgical complications in our study were rare. e rate of capsular tears was 0.33%, compared with reported rates as low as 0.55% [9], to more commonly reported rates of between 1.14% and 1.78% [10][11][12][13] or occasionally as high as 3.1% [14]. Vitreous loss in our study appeared in 0.33% of cases, compared with reported rates ranging from 0.34% [9] to 2.2% [14]; the incidence of zonular dehiscence (0.40%) and dropped nucleus (0.11%) is also similar or lower compared with that of other reports [10,14].…”

Section: Discussionmentioning

confidence: 76%

“…e rate of capsular tears was 0.33%, compared with reported rates as low as 0.55% [9], to more commonly reported rates of between 1.14% and 1.78% [10][11][12][13] or occasionally as high as 3.1% [14]. Vitreous loss in our study appeared in 0.33% of cases, compared with reported rates ranging from 0.34% [9] to 2.2% [14]; the incidence of zonular dehiscence (0.40%) and dropped nucleus (0.11%) is also similar or lower compared with that of other reports [10,14]. e low rate of intrasurgical complications in our study could be due to several factors: surgery was never performed by ophthalmologists in training and the cases included were operated recently (2017) and outcomes have been reported to improve with time [14][15][16].…”

Section: Discussionmentioning

confidence: 76%

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Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

Rementería-Capelo

García-Pérez

Gros-Otero

et al. 2020

Journal of Ophthalmology

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Introduction. Currently available outcome data for cataract surgery include mostly patients from public health systems. The purpose of this study was to report the visual and refractive outcomes of cataract procedures performed during one year in a private practice center, which may include a different spectrum of patients. Methods. Our center’s database was used to identify all isolated cataract procedures performed during 2017. The electronic records were reviewed to collect the preoperative information, presence of intra- or postsurgical complications, and visual and refractive outcomes one month after surgery. Results. In 2017, 2714 eyes of 1543 patients underwent cataract surgery in our center. Mean patient age was 70.42 years. 775 eyes (28.55%) had prior ophthalmic pathologies, and 113 eyes (4.16%) had undergone previous surgical procedures. Surgical complications developed in 35 eyes (1.29%), including 9 posterior capsule tears (0.33%) and 3 cases of dropped lens fragments (0.11%). A toric or multifocal intraocular lens was implanted in 45.6% of eyes. As regards postoperative complications, 59 eyes (2.17%) required a return to the operating theater, including 29 eyes (1.07%) requiring reinterventions due to an unexpected refractive result. There were no cases of endophthalmitis. Mean LogMAR-corrected distance visual acuity (CDVA) improved from 0.25 (SD 0.34) preoperatively to 0.04 (SD 0.17) postoperatively; 86.5% of eyes achieved a CDVA ≤0.0, with 97.5% achieving ≤0.3. In 86.4% of eyes, the difference between target and residual spherical equivalent difference was of 0.50 D or lower; 88% of eyes had a spherical equivalent ±0.50 D. Conclusions. The visual and refractive outcomes of cataract surgery in a private practice setting were excellent, well over the benchmarks set by the ESCRS. The safety profile was also within expected standards. This study provides information for ophthalmologists in private practice on expected outcomes.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 76%

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Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

Rementería-Capelo

García-Pérez

Gros-Otero

et al. 2020

Journal of Ophthalmology

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“…Using EMRs for research or audit is not a new idea, having been implemented in many fields of medicine to study diseases such as diabetes, heart failure, cancer and asthma 26. In eye clinics EMRs have been used for audit of cataract surgical outcomes but importantly also have potential for making healthcare delivery more efficient by facilitating more streamlined clinical work flow, better patient management and improved data tracking 11 27–32. However, ideas and implementation are different entities and meaningful use of EMRs in ophthalmology is still a work in progress 33–35.…”

Section: Discussionmentioning

confidence: 99%

Auditing service delivery in glaucoma clinics using visual field records: a feasibility study

et al. 2019

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ObjectiveThis study aimed to demonstrate that large-scale visual field (VF) data can be extracted from electronic medical records (EMRs) and to assess the feasibility of calculating metrics from these data that could be used to audit aspects of service delivery of glaucoma care.Method and analysisHumphrey visual field analyser (HFA) data were extracted from Medisoft EMRs from five regionally different clinics in England in November 2015, resulting in 602 439 records from 73 994 people. Target patients were defined as people in glaucoma clinics with measurable and sustained VF loss in at least one eye (HFA mean deviation (MD) outside normal limits ≥2 VFs). Metrics for VF reliability, stage of VF loss at presentation, speed of MD loss, predicted loss of sight years (bilateral VF impairment) and frequency of VFs were calculated.ResultsOne-third of people (34.8%) in the EMRs had measurable and repeatable VF loss and were subject to analyses (n=25 760 patients). Median (IQR) age and presenting MD in these patients were 71 (61, 78) years and −6 (–10, –4) dB, respectively. In 19 264 patients with >4 years follow-up, median (IQR) MD loss was −0.2 (−0.8, 0.3) dB/year and median (IQR) intervals between VF examinations was 11 (8, 16) months. Metrics predicting loss of sight years and reliability of examinations varied between centres (p<0.001).ConclusionThis study illustrates the feasibility of assessing aspects of health service delivery in glaucoma clinics through analysis of VF databases. Proposed metrics could be useful for blindness prevention from glaucoma in secondary care centres.

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Effect of preoperative keratometric astigmatism on uncorrected distance visual acuity after cataract surgery

Nghiem

Lin

Maurino

et al. 2022

J Cataract Refract Surg

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Going paperless: improved cataract surgery outcome data quality in a new fully electronic unit

Cited by 4 publications

References 3 publications

Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

Auditing service delivery in glaucoma clinics using visual field records: a feasibility study

Effect of preoperative keratometric astigmatism on uncorrected distance visual acuity after cataract surgery

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