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Cataract surgery refractive outcomes: representative standards in a National Health Service setting
  1. Kerr Brogan1,
  2. Charles J M Diaper2,
  3. Alan P Rotchford2
  1. 1 Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK
  2. 2 Ophthalmology Department, New Victoria Hospital, Glasgow, UK
  1. Correspondence to Dr Kerr Brogan, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow G12 0YN, UK; kerrbrogan{at}


Background/aims To report refractive outcomes from an National Health Service (NHS) cataract surgery service and assess if results meet suggested benchmark standard.

Methods Details of all patients undergoing cataract surgery in the Southern General and New Victoria hospitals in Glasgow, UK, between November 2006 and December 2016 were prospectively entered into an electronic database. Patients were reviewed 4 weeks postoperatively in the eye clinic and underwent refraction at their local optometrist prior to this appointment. Surgically uncomplicated cases with in the bag’ non-toric intraocular lens implantation were included. Patients with previous laser refractive procedures or failing to achieve 6/12 acuity or better postoperatively were excluded. Proximity to targeted postoperative refraction was documented.

Results Over this 10-year period, 11 083 eyes underwent cataract surgery. Of these, 8943 eyes of 6936 patients (80.69%) met the inclusion criteria and had both target and postoperative outcome refraction recorded. The mean difference between the targeted and outcome refraction was −0.07 D (SD 0.67). The mean absolute error was 0.50 D. Postoperative refraction was within 1 D of target refraction for 7938 eyes (88.76%) and within 0.50 D for 5577 eyes (62.36%).

Conclusion Refractive outcomes following routine cataract surgery reported here are well within the targets recommended by the Royal College of Ophthalmologists and European guidelines, but suggest that higher cataract refractive outcome benchmark standards may not yet be a realistic expectation for all NHS units with current biometry practice.

  • Lens and zonules
  • optics and refraction
  • treatment surgery

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  • Contributors KB collected and refined the data set, performed the literature search, and drafted the manuscript; CJMD designed and established the database, supervised data collection, and revised the manuscript; APR supervised the study, analysed the data, performed the statistical analysis, and revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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