Auckland cataract study 2: clinical outcomes of phacoemulsification cataract surgery in a public teaching hospital.
OBJECTIVE
A contemporary benchmark for the most common ophthalmic surgery.


BACKGROUND
To assess patient characteristics and outcomes of contemporary phacoemulsification cataract surgery in a New Zealand public teaching hospital setting.


METHODS
Prospective observational study.


METHODS
Consecutive cases (n = 500) of phacoemulsification surgery between April and June 2015.


METHODS
An independent observer assessed clinical and surgical data preoperatively and 4-6 weeks postoperatively.


METHODS
Visual acuity, intraoperative and postoperative complications.


RESULTS
Mean age was 72.3 ± 11.9 years and 57% female. Mean preoperative best-measured visual acuity was 6/30. Ocular comorbidity was present in 45.8% of eyes, most commonly glaucoma (10%), age-related macular degeneration (8%) and diabetic retinopathy (8%). Systemically, hypertension (59%) and diabetes mellitus (31%) were prevalent. Mean contralateral best-measured visual acuity was 6/12 (n = 495) with 62% being phakic. The rate of posterior capsular tear was 2.6% and cystoid macular oedema 3.5%. Intraoperative complication rates were not significantly different between surgeon levels (P = 0.234). However, registrars had fewer postoperative complications than fellows (2.2% vs. 11.9%, P = 0.012). Postoperatively, mean unaided and best-measured visual acuity were 6/12 and 6/9.


CONCLUSIONS
This study reports current phacoemulsification surgery outcomes in a major public teaching institution. A large proportion of patients exhibited systemic and ocular comorbidities, relatively dense cataracts and poor presenting visual acuity. However, visual outcomes and intraoperative complication rates were not statistically different between trainees and senior surgeons. Generally, outcomes reflect international standards and have improved since the last comparable study in this region.
Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand.|Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand.
Bia Z
http://orcid.org/0000-0003-2051-1521
BZ
Kim
Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand.|Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand.
Dipika V
DV
Patel
Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand.|Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand.
Charles Nj
CN
McGhee
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006779:Hospitals, Public; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D013997:Time Factors; D014792:Visual Acuity; D055815:Young Adult
cataract surgery; complication rate; observational study; visual outcome