Cataract surgery: reducing risk through better practice

Abstract

PurposeA guideline to the practice of cataract surgery was produced in 2004 by the Royal College of Ophthalmologists. This complemented a guideline to best practice produced in 2000 by the NHS Executive. This paper reviews the guidance given by these documents and examines their clinical governance and risk management advice and usefulness.Design/methodology/approachThe guideline is critiqued in terms of its usefulness to clinicians and health‐care managers. Recent research on the consenting process for cataract surgery is used as a benchmark of best practice and compared with the guideline's recommended methods. The medico‐legal caseload experience of The Medical Protection Society (the authors' institution) is used to discuss areas of concern relating to risk management in cataract surgery of interest to clinicians and managers.FindingsThe guideline is felt to be a useful, well‐produced and recommended resource for clinicians and managers with clinical governance responsibilities for cataract surgery services. There was felt to be scope to improve some of the guidance on reporting adverse events following cataract surgery to patients.Practical implicationsThis paper will help to inform the gaining of consent for cataract surgery in the light of the latest research in this area, and help train staff in this task.Originality/valueThis paper will be of value to clinicians and managers with responsibility for cataract surgical services. It should help to inform how they set up, review and audit their practice in this area and be useful for staff training. It highlights areas of the guideline which may be of relevance to those without time to read the whole guideline.