98th Annual Meeting DOG 2000

V 748

Microsurgical quality assurance in the field of cataract surgery

A. Händel, P. Martus, U. Schönherr, G. O. H. Naumann

Background: A prerequisit for quality assurance in the ophthalmic microsurgery is the complete collection of all surgery details including preoperative findings and postoperative follow-up ist. Data entry should be done online by the the surgeon himself immediately after the surgical procedure in the operation theatre.

Methods: Since 1986 all details of cataract extractions including eventual complications were documented by the surgeon himself immediately after surgery using a computer based surgery record system. 68,568 surgical procedures are documented by this electronic device up to now. To analyze the changing spectrum of cataract surgery in a university eye hospital we evaluated 12,653 consecutive cataract extractions split into five groups: 1990-91 (n=2,218), 1992-93 (n=2,295), 1994-95 (n=2,244), 1996-97 (n=2,774) und 1998-99 (n=3,122).

Results: Significant changes occured within the 5 periods named above in the following areas: Patient's age changed significantly (p<0.001), patient's gender showed no significant increase (p=0.34). Furthermore, there were shown a rising number of simultaneous surgical procedures (p<0.01) as weil as the appearance of pseudoexfoliations syndrome (p<0.001 ). The utilization of phacoemulsification increased significantly (p<0.001) as expected. Beyond this the time of hospitalization of cataract extraction shortened (p<0.001) and the occurence of vitreous loss decreased (p<0,001).

Conclusion: Long time observationsverified the expected changing trends of patients' spectrum at a university eye hospital. An increasingnumber of elderly patients were treated in our institution whereas genera"y, patient.s age undergoing cataract extraction decreases. Furthermore, there is a rising number of simultaneous surgical procedures as weil as more complicated surgical procedures. Despite this increasing patient's complexity combined with a decreasing postoperative duration no deterioration of result's quality was shown measured by the incidence of intrasurgical complications.

Department Ophthalmology, University of Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen