European trends in surgery

EUREQUO finds cataract severity and patient age declining, outcomes improving. Howard Larkin reports

Howard Larkin

Posted: Monday, February 1, 2021

Mats Lundström MD, PhD
Cataract patients are being treated earlier, while surgical complications have dropped and visual outcomes have improved in the past decade, Mats Lundström MD, PhD, Karlskrona, Sweden, told the 38th Congress of the ESCRS.
These findings reflect surgical trends across Europe drawn from more than 3.1 million cases reported to EUREQUO, the European Registry of Quality Outcomes for Cataract and Refractive Surgery, since its founding in 2007. Data in 2019 came from 330,202 cases reported from 16 countries.
Demographically, more men are now having cataract surgery, with women making up 56.7% of all patients in 2019, down from 60.6% in 2008. Mean age is dropping as well, to 73.4 years from 74.5 years 11 years earlier. Ocular comorbidities were reported in 27.9% of cases and a surgical difficulty in 9.8%.
Patient severity at the time of surgery trended down over the period, with mean CDVA falling to a mean value of 0.41 LogMAR from 0.46. Visual outcomes improved as well, to a mean CDVA of 0.04 LogMAR, with 78.4% at 0 LogMAR, or 6/6, and 96% at 0.3 LogMAR, or 6/12. Biometry prediction error stood at a mean of 0.39D and median of 0.28D with 74.4% within ±0.5D of target, Dr Lundström reported.
In terms of surgery, phacoemulsification made up 98-to-99% of procedures during the entire period with topical anaesthesia gaining ground to 77.9% of procedures in 2019. Hydrophobic acrylic lenses are also gaining favour, making up 78.5% of implants.
Surgical complications also continue to decline over time, Dr Lundström said. In 2019, intraoperative complications and postoperative complications both stood at 1.2%.
“Altogether it is a very bright picture of improving quality of cataract surgery.”
>Refractive outcomes
Based on 12,192 cases reported from 65 sites, mean age of refractive surgery patients in 2019 was 42.0 years with 48.7% female, Dr Lundström reported. Mean preoperative manifest refraction was -3.1D (-0.12D to – 16.75D) for myopia, and +1.75D (+0.10 to +11.75D) for hyperopia.
In this sample, refractive lens exchange dominated, accounting for 46.6%, including 38% receiving trifocal IOLs; followed by LASIK at 33.9%, including 32% with laser-cut flaps; LASEK at 7.5% and PRK at 6.0%.
EUREQUO allows surgeons to monitor their own results and compare them anonymously with other colleagues, clinics and countries, Dr Lundström said. A new feature supports audit reports based on surgeons’ own data.
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