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I collect outcome data on all my cataract operations, to allow me to check the accuracy of lens power calculations and astigmatic control, and to monitor possible complications.

Up until 2012 I used manual spreadsheet data entry; I now use the Medisoft electronic patient record system, further improving my ability to quality control ocular measurement and surgical outcomes. My surgical data contributes to the National Ophthalmic Database.

Audit Data 2012-2015 (Medisoft)

531 operations:

Pre-operative versus post-operative visual acuity (no co-morbidity)

91.2% 6/12 or better, unaided or with pinhole, at 2-3 weeks post-op

Accuracy of lens selection 2015

69% within 0.5 dioptres of target, 93% within 1 dioptre

Complications

0% posterior capsular tear (National data 5%, UK electronic patient record audit 2.68%)

1 case (0.15%) of endophthalmitis (infection) in an immunocompromised patient ((National data 0.3%, UK electronic patient record audit 0.6%)

Historical Data: Cataract audit 2002-2012

1534 operations
187 (12%) high risk
290 (19%) with pre-existing ocular comorbidity i.e. an expectation of reduced final vision because of a cause other than cataract, including age-related macular degeneration, diabetic retinopathy, amblyopia etc.

Outcomes (complete data on 1334 patients)

981 (93%) with unaided (no glasses) vision at least 6/12 where no pre-exisiting ocular co-morbidity exists; 1132 (85%) with unaided (no glasses) vision at least 6/12 including all cases.
(With glasses: National data 86%, UK electronic patient record audit 92%)
1213 (91%) within 1 dioptre of predicted refraction
Mean error from predicted refraction 0.02 dioptres
Mean change in astigmatism 0.18 dioptre reduction

Complications

8 (0.5%) posterior capsular tear +/- anterior vitrectomy
0 (0%) endophthalmitis (infection)

Audit data collection spreadsheet

Reference:

Cataract surgery guidelines 2004
Royal College of Ophthalmologists http://www.rcophth.ac.uk/docs/publications/CataractSurgeryGuidelinesMarch2005Updated.pdf