[Microsurgical quality assurance exemplified by cataract surgery].
BACKGROUND
The new German laws demand comprehensive quality assurance in all hospitals. The prerequisite for this in ophthalmic microsurgery is the complete documentation of all relevant surgical details including patient comorbidity.


METHODS
Since 1989 we have documented all microsurgical procedures using a computer-based surgery recording system. To analyze the changing spectrum of cataract surgery in a university eye hospital, we evaluated 12,653 consecutive cataract extractions divided into 5 periods between 1990 and 1999.


RESULTS
Within these periods the patients' age changed significantly (p < 0.001), whereas the gender showed no significant change (p = 0.34). Furthermore, there was an increase in the number of simultaneous surgical procedures (p < 0.01) as well as the frequency of the pseudoexfoliation syndrome (p < 0.001). In addition the mean duration of cataract procedures decreased (p < 0.001) and the occurrence of vitreous loss also decreased (p < 0.001).


CONCLUSIONS
Long-term documentation of all relevant patient data enables valid evaluation of the patient spectrum. Furthermore, this monitoring helps to manage the challenge of quality assurance in ophthalmology.
Händel
A
A
Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Qualitätsmanagement, Schwabachanlage 6, 91054 Erlangen. angelika.haendel@augen.imed.uni-erlangen.de
Martus
P
P
Küchle
M
M
Schönherr
U
U
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000592:standards*; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D005858:Germany; D006751:Hospital Information Systems; D006785:Hospitals, University; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008866:Microsurgery / Q000592:standards*; D008875:Middle Aged; D009870:Operating Room Information Systems; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011785:Quality Assurance, Health Care / Q000592:standards*; D012189:Retrospective Studies; D017749:Total Quality Management / Q000592:standards