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M.-J. Aubin, F. Djafari, R. Bruen, S. Couture, A. Laporte, J. Matteau, J. Gresset, H. Boisjoly; 1999-2006 - A Comparative Analysis of Factors Contributing to Wait Times for Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5447.
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To compare WT for cataract surgery between 1999 and 2006 and to look at the principal factors influencing the waiting list apart from the population dynamics: VA threshold for cataract surgery and cataract surgical rates (CSR).
Comparative prospective study of patients enlisted for first-eye cataract surgery at Maisonneuve-Rosemont Hospital (MRH), Montreal, in 1999 and in 2006. 594 patients (507 in 1999 and 85 in 2006) underwent a detailed visual exam including VA (logMAR) within four weeks prior to surgery. Functional measures of cataract severity were obtained using the VF-14 and the Cataract Symptom Score (CSS) questionnaires. WT (days) were obtained from the surgical waiting list. The CSR (cataracts operated per million population per year) were also calculated for the population pool in the catchment area of MRH (0.5 million population).
WT decreased from a mean of 180.95 days (approximately 6 months) in 1999 to 119.11 days (approximately 4 months) in 2006 (p < 0.05). The VA threshold for cataract surgery decreased from 0.57 logMAR (6/24) in 1999 to 0.42 logMAR (6/15) in 2006 (p < 0.05). Functional measures of cataract severity also reflected this decrease in surgical threshold with a better score on both the VF-14 and the CSS in 2006 (V-14 74.77; CSS 4.9) compared to 1999 (VF-14 64.66; CSS 5.7) (p < 0.05). The CSR increased from 3174 (1587 cataracts operated/0.5 million population/year) in 1999 to 7776 (3888 cataracts operated/0.5 million population/year) in 2006 (p < 0.05).
Although there has been a greater patient load driven both by the population dynamics and the reduced VA threshold, the cataract surgical output more than doubled with the opening of an OR specially dedicated to cataract surgery. Care should be taken in the selection of patients for cataract surgery to avoid putting pressure on the system.
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