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The Malaysian Cataract Surgery Registry: Cataract Surgery Practice Pattern
Ming-Yueh Lee1, Pik-Pin Goh, Mohamad Aziz Salowi
1From the *Department of Ophthalmology and †Clinical Research Centre, Kuala Lumpur Hospital, Kuala Lumpur; ‡Department of Ophthalmology,Sarawak General Hospital, Sarawak; and §Department of Ophthalmology,Selayang Hospital, Selangor, Malaysia.
Purpose:
To present the cataract surgery practice pattern among the ophthalmic surgeons in hospitals managed by the Ministry of Health (MOH) in Malaysia.
Design:
Secondary data analysis on Malaysian Cataract Surgery Registry (CSR).
Methods:
The Malaysian CSR collected data on cataract surgeries done at all the ophthalmology departments in MOH from year 2002 to 2004 (paper-based) and 2007 to 2011 (web-based). Data collected include type of admission, surgical techniques, type of anesthesia, and intraocular lens (IOL). Descriptive and inferential analysis was performed.
Results:
Of the 185,388 cataract surgeries done over 8 years, 171,482 (91.5%) were captured in CSR. There was a steep rise in phacoemulsification cataract surgery from 39.7% in 2002 to 78.0% in 2011 with a corresponding fall in extracapsular cataract extraction from 54.0% to 17.3% in the respective years. This explained the surge in the use of foldable IOL from 26.5% in 2002 to 88.3% in 2011. The proportion of cataract surgery with IOL implantation was 97.5% in 2012 and 98.2% in 2011. The proportion of day-care cataract surgery was low, with 39.3% in 2002 to 52.3% in 2011. Vitreoretinal surgery was the commonest type of combined surgery performed.
Conclusions:
Although phacoemulsification was performed in two thirds of the patients who presented to MOH hospitals in Malaysia, extracapsular cataract extraction was still being performed because of a significant proportion of cataract that were brunescent and limited access to phacoemulsification machines and consumables. There is a need to increase day-care cataract surgery as it will eventually save cost.