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Anthony Choi, Gary J Lelli; Outcomes in cataract surgery at a major tertiary center: an effort towards improvement in quality reporting. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2536.
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In the era of quality metrics in healthcare, many expect that ophthalmologists will eventually be reporting outcomes for the most commonly treated ocular diseases. To date, performance reporting for quality improvement in the field of ophthalmology has been relatively unsuccessful in Europe and essentially non-existent in the United States. Our primary goal is to provide data on visual outcomes after cataract extraction surgery at a major tertiary center in order to improve upon quality measures and outcomes reporting in ophthalmology.
We reviewed all cataract surgeries performed from June 2012 to December 2012 at a single institution to compare best-corrected visual acuity (BCVA) before and after the procedure. Inclusion required documented BCVA up to three months prior to surgery and between one to six months after surgery. The first month following surgery was not taken into account to allow for a recovery period. Patients were excluded if they had significant ophthalmologic histories other than cataracts in the operative eye.
During this time period, 361 cataract surgeries were performed, of which 229 (63.4%) met the inclusion criteria. Of the included cases, 226 (98.7%) resulted in a postoperative BCVA of 20/40 or better. Of the excluded cases, 109 (82.6%) were excluded due to insufficient data and 23 (17.4%) for pre-existing ocular disease. Average pre- and postoperative BCVA were 20/85.4 (SD=101) and 20/23.7 (SD= 13.7), respectively.
Cataract outcomes can be reported at a major tertiary care center. Cataract surgery in this setting almost always results in significant improvement in BCVA. By providing data from our center, we strive to add to the ongoing discussion on establishing the best outcome metric, deriving the optimal benchmark for success rates, and identifying the factors that affect surgery outcomes, all of which play a critical role in improving the quality of care in our field.
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