338 Qualité dans la chirurgie de la cataracte chez des patients : efficacité, défaut résiduel et meilleure acuité visuelle après un mois

Abstract

Objectif Evaluate quality, efficacy, residual defect and best visual result after cataract surgery in concerted series. Materials and Methods We have studied 189 eyes of 189 consecutive patients. Cataract surgery was performed during the month of june, 2008. Corneal incision in the steepest axis, phacoemulsification and Acrysoft MN60BM intraocular lens implantation under topic anesthesia were carried out according to protocol. Preoperative visual acuity, pathology, complications, best visual acuity, residual sphere and cylinder at the end of the follow-up were studied. Safety was determined as the percentage of eyes that had a best corrected visual acuity equal or greater than before the surgery. The 2007 European Cataract Outcome Study data were considered as benchmarking. Results Age: 76±7 years (range 53-93). Patients older than 70 years: 82,1%. Women percentage: 61%. Diabetics: 18,5%. Previous visual acuity: 0,16±0,13. Previous visual acuity lower than 0,50: 98,9%. Follow-up: 33±7 days (range 18-112). Final visual acuity average: 0.8±0.2. Final visual acuity ≥0,8: 67,2%. Final visual acuity ≥0,9: 48,1%. Final visual acuity ≥1,0: 12,2%. Patients with no residual sphere or cylinder: 21,7%. No residual sphere: 52,9%. Residual sphere ±0,25D: 66,7%. Residual sphere ±0,50D: 84,6%. Residual sphere ±1,00D: 97,9%. Residual cylinder: –0.62±0,46D (range 0.00 / –2.25). No residual cylinder: 27,5%. Residual cylinder ±0,75D: 71,9%. Safety: 100% Discussion The group is older than the 2007 ECOS average. They had very low previous visual acuity. The percentage of diabetic patients does not reflect the diabetic retinopathy data. As today the cataract surgery have a part of refractive surgery, our quality indicators measure the percentage of eyes that have a residual sphere between ±0,25 diopters, and the percentage of eyes with residual cylinder ≤0,75 diopters. We are on the way to have uniform criteria in outcomes, safety and efficiency, as it is expected in the European Registry of Quality Outcomes in cataract and refractive surgery Conclusion Despite the existence of some variability in this group, good safety, visual and refractive results were obtained.