Quality improvement in cataract care
The College recommendations for supporting information in cataract surgery are as follows:
It is expected that ophthalmologists who perform cataract surgery will, as a minimum, provide the following supporting information for appraisal:
Once in each five year revalidation cycle: a detailed audit of at least 50 consecutive cataract operations with themselves as the primary surgeon, to include preoperative and postoperative visual acuities, postoperative visual acuity, intended refractive outcome and actual refractive outcome, with a reasonable degree of completeness of data
An annually-updated record of the total number of cataract operations they have performed in the revalidation cycle including a record of all cases which were complicated by posterior capsule rupture,endophthalmitis <– LINK TO PAGE, or other operative or postoperative complications which resulted in additional interventions or a poor visual outcome.
Ophthalmologists who provide care for patients with cataract may also wish to consider the following optional topics for audit:
- Perceptions by patients and carers of the quality of care provided by the service
- Accuracy of biometry
- The development of optically significant posterior capsule opacification <— LINK TO PAGE
- Correct use of the WHO/NPSA preoperative checklist
The items of information which are “expected” for appraisal have been required as part of the specialty training curriculum for ophthalmology for several years and the College believes that it is a reasonable minimum requirement for the revalidation of all ophthalmologists who undertake cataract surgery and should be achievable even where the ophthalmologist is entirely reliant on paper records and manual data collection methods. Ophthalmologists who have access to an electronic clinical record system for cataract care will usually be able to provide more extensive and detailed supporting information.