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Published on: July 7, 2023
Appropriateness of phacoemulsification in Spain
Nerea Fernández de Larrea1, Juan Antonio Blasco, Urko Aguirre
1Unidad de Evaluación de Tecnologías Sanitarias, Agencia Laín Entralgo, C/ Gran Vía 27, 28013 Madrid, Spain. nerea.fernandez@salud.madrid.org
Summary
Phacoemulsification cataract surgery was appropriate in 69.6% of cases. Factors like ocular comorbidity and limited visual function impacted appropriateness, highlighting the need for careful risk-benefit assessment in phacoemulsification procedures.
Area of Science:
- Ophthalmology
- Health Services Research
Background:
- Cataract extraction is a common surgical procedure.
- Phacoemulsification is the predominant technique used for cataract removal.
- Evaluating the appropriateness of surgical procedures is crucial for healthcare quality.
Purpose of the Study:
- To assess the appropriateness of phacoemulsification procedures in Spain.
- To identify factors influencing the appropriateness of cataract surgery.
Main Methods:
- Prospective observational study involving 5442 patients.
- Utilized RAND/UCLA appropriateness methodology criteria.
- Data collected from 17 public teaching hospitals across four Spanish regions.
Main Results:
- Phacoemulsification was deemed appropriate in 69.6% of cases, inappropriate in 7.3%, and uncertain in 23.0%.
- Factors associated with inappropriateness included ocular comorbidity, lack of visual limitation, anticipated postoperative visual acuity <0.5, preoperative visual acuity >0.1, and high surgical complexity.
Conclusions:
- Clinical characteristics significantly influence the appropriateness of phacoemulsification.
- Careful assessment of risks and benefits is essential, particularly in cases with specific clinical indicators.
- Improving patient selection and risk stratification can enhance the appropriateness of cataract surgery.
