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RCOphth concerned at the continued restriction of second eye cataract surgery by CCGs

10 December 2015

The Royal College of Ophthalmologists is concerned to hear that there continues to be a restriction of second eye cataract surgery by some CCGs.

The RCOphth stresses that the decision to perform second eye cataract surgery should be based entirely on clinical need.

A report by the Scottish Health Technologies Group (Healthcare Improvement Scotland) identified evidence from a randomised controlled trial demonstrating that second eye cataract surgery is cost-effective over an individual’s lifetime, and concluded that “individual patient need should always be considered in prioritising access to second-eye cataract surgery”.

In February 2015 RCOphth published NICE approved Commissioning Guide: Cataract Surgery  which outlined recommendations regarding second eye cataract surgery.

This guidance is in keeping with the NIHR funded HTA systematic review of second eye cataract surgery which concluded that this procedure is highly cost effective with an incremental cost effectiveness ratio below £2,000 / QALY (i.e. one tenth of the NICE threshold).

Cataract surgery is one of the most cost efficient surgeries in the NHS, with over 300,000 routinely performed in England alone. We believe that any restriction to second eye surgery made through commissioning decisions will not produce the efficiencies or cost savings expected.

RCOphth and our members can work directly with service providers and commissioning groups to review models of care if needed. We urge service providers and commissioning groups to ensure that patients are given the best and most appropriate care, based on clinical need.