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Auckland Cataract Study 2: clinical outcomes of phacoemulsification cataract surgery in a public teaching hospital.

Auckland Cataract Study 2: clinical outcomes of phacoemulsification cataract surgery in a public teaching hospital.
Author Information (click to view)

Kim BZ, Patel DV, McGhee CN,


Kim BZ, Patel DV, McGhee CN, (click to view)

Kim BZ, Patel DV, McGhee CN,

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Clinical & experimental ophthalmology 2017 02 07() doi 10.1111/ceo.12922
Abstract
IMPORTANCE
A contemporary benchmark for the most common ophthalmic surgery.

BACKGROUND
To assess patient characteristics and outcomes of contemporary phacoemulsification cataract surgery in a New Zealand public teaching hospital setting.

DESIGN
Prospective observational study.

PARTICIPANTS
Consecutive cases (N = 500) of phacoemulsification surgery between April and June 2015.

METHODS
An independent observer assessed all clinical and surgical data pre-operatively and 4-6 weeks post-operatively.

MAIN OUTCOME MEASURES
Visual acuity, intra-operative and post-operative complications.

RESULTS
Mean age was 72.3 ± 11.9 years and 57% female. Mean pre-operative best-measured visual acuity (BMVA) was 6/30. Ocular comorbidity was present in 45.8% of eyes, most commonly glaucoma (10%), age-related macular degeneration (8%) and diabetic retinopathy (8%). Systemically, hypertension (59%), diabetes mellitus (31%) and ischaemic heart disease (21%) were prevalent. The mean contralateral BMVA was 6/12 (N = 495) with 62% being phakic. The rate of posterior capsular tear was 2.6% and cystoid macular oedema 3.5%. The rate of intra-operative complications was not significantly different between surgeon levels (P = 0.234). However, registrars had fewer post-operative complications than fellows (2.2% vs 11.9%, P = 0.012). Post-operatively, mean unaided and BMVA were 6/12 and 6/9.

CONCLUSIONS AND RELEVANCE
This study provides a current assessment of phacoemulsification surgery outcomes in a major public teaching institution. A large proportion of patients exhibited systemic and ocular co-morbidities, relatively dense cataracts and poor presenting visual acuity. However, visual outcomes and intra-operative complication rates were not statistically different between trainees and senior surgeons. Generally, outcomes reflect international standards and have improved since the last comparable study in this region.

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