Cataract surgery audit at a Sydney metropolitan teaching hospital

Purpose: To assess visual outcomes and complication rates from phacoemulsification cataract surgery at a major Sydney teaching hospital. Method: Retrospective audit of medical records of patients having phacoemulsification cataract surgery in 2015. Outcomes measured: best-corrected visual acuity (BCVA), anaesthesia type, antibiotic use and complication rates. Statistical analysis was performed using Pearson’s chi-square analysis. A p-value<0.05 was considered significant. Results: Eight hundred cataract surgeries (778 alone, 22 combined with another procedure) were performed in 724 patients (42.1% males; mean age 73.6 ±9.3 years). The principal surgeon was documented as a consultant 361 (46.4%), supervised trainee 398 (51.2%) or combined 15 (1.9%). Main wound incision was clear corneal 758 (97.4%), limbal 18 (2.3%) or scleral tunnel 2 (0.3%). Major intraoperative complications included anterior capsular tear 5 (0.6%), dropped nucleus 1 (0.1%), posterior capsular tear (PCT) with vitreous loss 3 (0.4%), PCT without vitreous loss 7 (0.9%) and zonular dehiscence/laxity 5 (0.6%). Intraoperative complication rates were comparable between consultants 22 (2.8%) and supervised trainees 29 (3.7%) (p=0.6). Postoperative complications included cystoid macular oedema 32 (4.2%), prolonged inflammation 11 (1.4%) and wound leak 1 (0.1%). There was no endophthalmitis. Anaesthetic technique was documented as subtenon block 422 (54.2%), peribulbar block 309 (37.7%) or general anaesthesia 28 (3.6%). Antibiotic use included intracameral 570 (73.3%) and subconjunctival injections 193 (24.8%). No antibiotics were administered in 15 eyes (1.9%). BCVA ≥ 6/12 was achieved in 580 eyes (74.6%). Target refraction within ±1D was achieved in 676 eyes (86.9%). Conclusion: Phacoemulsification outcomes at our institution are consistent with international benchmarks.