European registry for quality improvement in cataract surgery

A project aimed at creating a multi-national database for cataract and refractive surgery was initiated in 2008. The database was intended for learning and clinical improvement, not supervision. The project was co-funded by the European Union, under the Executive Agency for Health and Consumers and the European Society of Cataract and Refractive Surgeons (ESCRS) and supported by 11 national societies for cataract and refractive surgery. The purpose of this article is to describe the setup of the database and the ensuing achievements within cataract surgery after four years.

A web-based system was created for input and output of data, with a software interface to two databases, one for cataract surgery and one for refractive surgery. Data can be put in either manually through web forms or by transfer of data from existing national registries or large electronic medical record systems. Output of reports from the system or export of one's own data is available on the web. The data are anonymous to all users, with the sole exception that reporting surgeons and clinics have access to their own data. The system does not include any patient identification.

After four years, data from 16 countries have been entered into the system, including reports of more than 900,000 cataract extractions. The database has been used by individual clinics for benchmarking and clinical improvement work, and has also served as the basis for new clinical guidelines for cataract surgery. The ESCRS has guaranteed the sustainability of the database after the project period.

A European quality registry with data input from surgeons and clinics in 16 European countries has been established. Close to one million surgeries have been entered into the system during the first four years. Evidence-based guidelines have been published based on data in the registry. The system is used for benchmarking by both experienced surgeons and trainees.