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The Royal College of Ophthalmologists publish the first annual report of the National Ophthalmology Database Audit

11 April 2016

Cataract surgery is one of the most frequently performed surgical procedures in the UK with around 330,000 operations performed yearly in England and 16,000 in Wales.

In the first annual report of the National Ophthalmology Database Audit, published by The Royal College of Ophthalmologists, ‘historic’ or ‘legacy’ data have been used to highlight data completeness and to establish a robust methodology for future cataract surgery audit cycles.

Posterior capsule rupture (PCR) is a complication in cataract surgery and it happens on average in about 1 operation out of 50.  When this problem occurs, further surgical steps are required and the risk of a poor result is increased. It is important to know if the patient’s vision has improved or become worse after a cataract operation so the audit will examine both PCR and visual acuity (VA) loss from before to after surgery to determine the standards of care provided by cataract services.

This initial report analyses the surgical complication rate of PCR and VA loss on over 75,000 cataract operations performed on adult patients during the April 2014 – March 2015 NHS year in 34 NHS cataract surgical centres across England. This represents about 20% of all eligible cataract surgery during this period. The first phase of the audit found that none of the outcomes for the contributing surgeons and centres fell outside the nationally acceptable statistical range for the 2014-15 NHS year audited.

Professor John Sparrow, Consultant Ophthalmologists at Bristol Eye Hospital and National Audit Clinical Lead, commented These initial retrospective results are reassuring in terms of testing the audit methodology and indicate that surgery in the early adopter pilot sites is being delivered to an acceptable standard. Certain areas where data completeness could be improved have been highlighted, and looking ahead the audit team will be encouraging participating centres towards greater data completeness for forthcoming audit cycles. ”

The next phase of development of the audit will be prospective, with all centres providing NHS funded cataract surgery in England and Wales being invited to participate. Currently 96 NHS trusts and Health Boards intend participating in the prospective audit which accounts for around three quarters of all the eligible ‘traditional NHS’ cataract surgery providers in England and Wales. The prospective audit report, to be published in 2017, will include risk adjusted cataract surgery outcomes for named surgeons and named centres for the period September 2015 to August 2016.

The legacy data only includes contributing centres from England, the prospective audit will however include information from England and Wales.

The National Ophthalmology Audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes programme (NCAPOP). The audit will initially concentrate on NHS funded cataract surgery in England and Wales, with feasibility studies for possible future audits on glaucoma, retinal detachment and age-related macular degeneration.  The audit will identify cataract surgery outcomes with a view to improving patient care and providing reassurance to the public that cataract surgical services are being delivered to acceptable standards.

Read the full report here