歯学ジャーナル
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概要

Quality Assessment of Cataract Surgery in Denmark

Søren Solborg Bjerrum

Background: To assess the quality of cataract surgery in Denmark by studying the epidemiology of cataract surgery in Denmark during the last decade and by examining the risks of pseudophakic retinal detachment (PRD) and postoperative endophthalmitis (PE).

Methods: A ph.d. thesis based on four register- and chart based studies.

Results: It was found that over a 10 year calendar period a cataract operation increased the risk of PRD by a factor 4.2. Age and sex were statistically significant risk factors for retinal detachment but the effect of cataract surgery on the risk of retinal detachment per se was not statistically significantly modified by age and sex. The risk of PE at public eye departments was about 4 per 10000 registered cataract operations. A few private clinics had a statistically significantly higher risk of PE following registered cataract surgery compared to public eye departments. Out of 121 cases of PE, a complication after surgical intervention for PE occurred in 27% of all cases. Overall, a vitreous tap was not associated with a statistically significantly higher risk of surgical complications compared to a pars plana vitrectomy. Patients who underwent cataract surgery in private clinics were operated at an increasingly younger age and were healthier compared to patients who underwent cataract surgery in public hospitals. In general, there was a lack of registration of cataract surgery by the private clinics.

Conclusions: The risks of PRD and PE can be used as quantitative indicators of the quality of cataract surgery in Denmark, but the lack of registration of cataract surgery by private clinics limits the quality of the Danish cataract registries. A more complete registration of cataract surgery in Denmark will make it easier to assess and monitor the quality of cataract surgery in the future.