National biometry audit.
OBJECTIVE
To determine compliance with the Royal College of Ophthalmologists' (RCOphth) biometry guidelines.


METHODS
A structured telephone questionnaire of individuals who perform biometry in all eye departments in the United Kingdom (UK).


RESULTS
A biometrist was interviewed in 107 of the UK's 178 eye departments. Nurses alone run the biometry service in 58% of departments, orthoptists alone in 13%, junior doctors alone in 6%, optometrists alone in 3%, and a combination of staff in 20%. Of the staff interviewed, 37% had been on external biometry training courses. One intraocular lens (IOL) calculation formula was used for all eyes in 61% of departments with 17% using the obsolete SRK II formula, 36% of departments used two or more formulae and only 4% adhered to the RCOphth guidelines to use Hoffer Q in eyes with axial lengths <22.0 mm, an average of all three formulae in eyes between 22.0 and 24.5 mm, Holladay in eyes between 24.6 and 26.0 mm, and SRK/T in eyes >26.0 mm. Audit of refractive results was claimed by 71% of units but in only 17 (16%) did the biometrist know the percentage of eyes with a prediction error <or=1 D.


CONCLUSIONS
This study demonstrates poor awareness and/or implementation of the RCOphth biometry guidelines and indicates that audits are either not highlighting poor results or are not resulting in a change in practice. The guidelines should be updated to emphasise the importance of customising A constants and to set benchmark standards for prediction error.
Gale
R P
RP
Department of Ophthalmology, Addenbrookes Hospital, Cambridge, UK.
Saha
N
N
Johnston
R L
RL
D001699:Biometry / Q000379:methods*; D002387:Cataract Extraction; D004496:Education, Continuing / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007910:Lenses, Intraocular; D008485:Medical Audit; D009885:Ophthalmology / Q000193:education; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000592:standards; D012029:Refraction, Ocular; D012955:Societies, Medical; D006113:United Kingdom