Complications after cataract surgery in Medicare patients down significantly since 1994

Ophthalmology. 2011;118(9):1716-1723

Rates of adverse events after cataract surgery among Medicare beneficiaries diminished steadily between 1994 and 2006, a large study found.

"Although modern cataract surgery is considered a safe and effective procedure, it is not without risk," the study authors said. "Future efforts should be directed to identifying ways to reduce severe adverse events in high-risk groups."

The retrospective longitudinal cohort analysis included 221,594 Medicare beneficiaries who underwent their first cataract surgery between 1994 and 2006. Beneficiaries were classified into three cohorts: those who had cataract surgery in 1994-1995 (57,780 patients), 1999-2000 (73,064 patients) and 2005-2006 (90,750 patients).

Records showed that 214,468 cataract surgeries (97%) were not combined with other intraocular procedures; 7,126 surgeries (3%) were combined with other procedures.

Mean patient age at the time of surgery was 77.5 years. Patients were followed for 1 year postoperatively.

Investigators determined 1-year rates of endophthalmitis, suprachoroidal hemorrhage and retinal detachment for each cohort.

Results showed that 1,086 patients (0.5%) experienced at least one severe postoperative complication. Adjusted data showed that patients who had cataract surgery in 1994-1995 had a 21% higher hazard of severe postoperative complications than those who had surgery in 2005-2006. Patients who had surgery in 1999-2000 had a 20% higher hazard than those who had surgery in 2005-2006.

The probability of a severe complication was 0.6% in 1994-1995, 0.5% in 1999-2000 and 0.4% in 2005-2006. The first two cohorts had a statistically significantly higher probability of complications than the third cohort (both P < .001), the authors said.