Reducing wait time for cataract surgery: comparison of 2 historical cohorts of patients in Montreal.
OBJECTIVE
A cataract efficiency program was implemented in Montreal in 2003 to decrease surgery wait time. Our goal was to determine whether health, adverse events during wait time, and outcome of patients presenting for cataract surgery differed from 1999 to 2006 in Montreal.


METHODS
Prospective preoperative and postoperative observational study performed at 2 time points 6 years apart.


METHODS
Patients awaiting first-eye cataract surgery at Maisonneuve-Rosemont Hospital: 509 patients in 1999-2000 and 206 patients in 2006-2007.


METHODS
Patients awaiting first-eye cataract surgery were recruited from Maisonneuve-Rosemont Hospital in 1999-2000 (n = 509) and a second cohort was recruited in 2006-2007 (n = 206). Date of entry onto the hospital waiting list and date of cataract surgery were recorded. About 2 weeks before surgery, patients were asked about accidents and falls while waiting, visual difficulty, and satisfaction with vision and wait time. Visual acuity was measured in each eye. Patients also completed interviewer-administered questionnaires: the 5-item Cataract Symptom Scale, Visual Function-14 Questionnaire (VF-14), Short Form Health Survey-36, Geriatric Depression Scale, and the 14-item Systemic Comorbidity Scale. The interview was repeated after surgery.


RESULTS
In 1999, 39% of patients waited more than 6 months for cataract surgery, and this was reduced to 29% in 2006. Patients had better preoperative visual acuity in the surgical eye, less visual difficulty, and fewer cataract symptoms, and reported fewer accidents while waiting for surgery in 2006. The change in visual acuity after surgery was nonetheless the same in the 2 cohorts. The 2006 cohort achieved significantly higher VF-14 scores and reported more satisfaction with vision after surgery than did the 1999 cohort.


CONCLUSIONS
Patients had cataract surgery sooner in the disease process in 2006-2007 compared with 1999-2000, with changes in visual acuity after surgery that were clinically significant in both cohorts.
Boisjoly
Hélène
H
Department of Ophthalmology, Research Center, Hôpital Maisonneuve-Rosemont, Montreal, Que. helene.boisjoly@umontreal.ca
Freeman
Ellen E
EE
Djafari
Fawzia
F
Aubin
Marie-Josée
MJ
Couture
Simon
S
Bruen
Robin P
RP
Gizicki
Robert
R
Gresset
Jacques
J
D000368:Aged; D002387:Cataract Extraction; D003695:Delivery of Health Care; D005260:Female; D006284:Health Plan Implementation; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011446:Prospective Studies; D011792:Quebec; D011795:Surveys and Questionnaires; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology; D014850:Waiting Lists