Appropriateness of phacoemulsification in Spain.
OBJECTIVE
To evaluate the appropriateness of phacoemulsification procedures performed in four Spanish regions, applying criteria developed by means of RAND/UCLA methodology.


METHODS
Prospective observational study.


METHODS
Seventeen public teaching hospitals in four regions of Spain.


METHODS
Patients on waiting list to undergo cataract extraction by phacoemulsification.


METHODS
Cataract surgery by phacoemulsification.


METHODS
Level of appropriateness of each intervention, according to criteria developed by means of the RAND/UCLA appropriateness methodology.


RESULTS
Among the 5442 analysed patients the indication of phacoemulsification was appropriate in 69.6%, inappropriate in 7.3% and uncertain in 23.0%. Presence of ocular comorbidity, lack of cataract-induced visual function limitation, anticipated postoperative visual acuity of <0.5, preoperative visual acuity of >0.1 and high surgical complexity were associated with inappropriateness.


CONCLUSIONS
Some clinical characteristics, when present, make it especially important to obtain a careful assessment of the risks and benefits of surgery. Consideration of these characteristics may improve the appropriateness of phacoemulsification.
de Larrea
Nerea Fernández
NF
Unidad de Evaluación de Tecnologías Sanitarias, Agencia Laín Entralgo, C/ Gran Vía 27, 28013 Madrid, Spain. nerea.fernandez@salud.madrid.org
Blasco
Juan Antonio
JA
Aguirre
Urko
U
García
Susana
S
Elizalde
Belén
B
Navarro
Gemma
G
Pérez
Sabina
S
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013030:Spain; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*