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Ridley Medal Lecture focuses on role of cataract registries to assess real world outcomes
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MILAN — Cataract registries have played a major role in assessing outcomes and establishing benchmark standards over the past two decades. They give the real-world scenario of how cataract surgery outcomes have progressed over time, of the weak points that still remain and of the impact of social changes on outcome targets.
"If we look at trends, we can see that over the years visual acuity outcomes have improved and complication rate has significantly lowered, but if we look at patient-reported improvement, we have a sort of a standstill and even a little decline," Mats Lundström, MD, said during the Ridley Medal Lecture at the European Society of Cataract and Refractive Surgeons meeting.
Mats Lundström
In Lundström's opinion, the most likely reason for this is that surgeons have "pushed the indications for cataract surgery forward."
"As long as we did cataract surgery to avoid blindness and visual disabilities, we got patient-reported improvement. But now that we have started operating cataract for refractive purposes or even preventive reasons in a much larger number of patients, high expectations may lead to dissatisfaction after surgery," he said.
Success in achieving target refraction is still limited to about half of cases, data show, mainly due to IOL calculation errors and astigmatism.
Collecting data on surgical outcomes is part of the surgeon's responsibility and offers an opportunity to learn and improve, Lundström said.
"We need to know hard facts in terms of numbers. To really find out about one's surgical results is, after all, a matter of courage," he said.
From 1995 to now, the European Cataract Outcome Study, the Swedish National Cataract Register and the European Registry of Quality Outcomes for Cataract and Refractive Surgery have provided data on nearly 2.5 million cataract procedures in Europe.