Original articlePreoperative Vision and Surgeon Volume as Predictors of Visual Outcomes after Cataract Surgery
Section snippets
Methods
A retrospective cohort study was performed on patients enrolled in the Kaiser Permanente Southern California Health Plan who underwent cataract surgery between January 1, 2013 and December 31, 2015. The Kaiser Permanente Southern California Institutional Review Board approval was attained, and the tenets of the Declaration of Helsinki were followed. Patients were excluded from this study if they had any of the following criteria:
- 1.
Less than 18 years old at the time of surgery.
- 2.
Surgeries were
Results
A total of 136 surgeons performed 106 962 surgeries, of which 103 920 (97.3%) met inclusion criteria. Mean patient age at the time of surgery was 72 years (18–105 years). The majority (57.7%) of the patients were female, and 11.4% had a prior diagnosis of diabetic retinopathy. Table 1 provides a summary of baseline characteristics.
The distribution of preoperative vision was similar between surgeon volume categories: ≤149 surgeries, 150–249 surgeries, 250–349 surgeries, 350–449 surgeries, and
Discussion
Good postoperative vision was the norm after cataract surgery in this large and diverse cohort, with most patients achieving 20/25 or better vision. A total of 28% of all patients had better than 20/25 preoperative vision, which demonstrates that most surgeons were willing to perform surgery even in those with good preoperative vision. It may seem intuitive that higher-volume surgeons achieve such surgical numbers by having a lower visual threshold to perform surgery; however, the distribution
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Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
D.F.S.: Grant funding outside this study – Allergan, ThromboGenics, Regeneron, Nightstar.
Funding provided by the Kaiser Permanente Center for Effectiveness & Safety Research.
HUMAN SUBJECTS: Human subjects were included in this study. The Kaiser Permanente Southern California Institutional Review Board approved the study and waived the need for patient consent for this retrospective study. All research adhered to the tenets of the Declaration of Helsinki.
No animal subjects were used in this study.
Author Contributions:
Conception and design: Modjtahedi, Hull, Adams, Munz, Luong, Fong
Analysis and interpretation: Modjtahedi, Hull, Adams, Munz, Luong, Fong
Data collection: Modjtahedi, Hull, Adams, Munz, Luong, Fong
Obtained funding: Funding provided by the Kaiser Permanente Center for Effectiveness & Safety Research.
Overall responsibility: Modjtahedi, Hull, Adams, Munz, Luong, Fong