Quality improvement in vitreoretinal surgery
The College recommendations for supporting information in vitreoretinal surgery are as follows:
It is expected that ophthalmologists who undertake vitreoretinal surgery should participate in audit of their surgical outcomes in each 5 year revalidation cycle. The College’s Informatics and Audit Sub-committee and the British and Eire Association of Vitreoretinal Surgeons (BEAVRS) have developed data sets for audit of the following commonly performed procedures and recommend their use for this purpose:
Although published series of primary retinal reattachment procedures often report success rates of 85% or more with one or more procedures, the probability of success in an individual case depends on many factors including the duration of retinal detachment, size and distribution of retinal breaks, presence of vitreous pathology and the presence of proliferative vitreoretinopathy. Proliferative vitreoretinopathy is the most common cause of persistent failure to achieve retinal reattachment.
It is recommended that in each 5 year revalidation cycle a vitreoretinal surgeon present an audit of either 50 cases of macular hole surgery and/or retinal detachment surgery using the above data sets.
Examples of supporting information which may be included in the quality improvement section of an ophthalmologist’s portfolio may also include:
- Visual or quality of life outcomes following primary retinal detachment surgery
- Visual or quality of life outcomes of epiretinal membrane surgery
- Outcomes of surgery for diabetic retinopathy in terms of:
o Stabilisation of retinopathy
o Visual function
- Audit of the timeliness of primary surgery for patients presenting with retinal detachment
- Complications of vitreoretinal surgery requiring further intervention such as retinal detachment or persistent wound leak.