OUTCOME OF 1000 CONSECUTIVE CLINIC-BASED AND HOSPITAL-BASED CATARACT SURGERIES IN A DANISH COUNTY

Purpose: To evaluate the homogeneity and quality of cataract surgery i n a Danish county. Setting: Four private eye clinics and the Departmen t of Ophthalmology, Hillerod Hospital, Frederiksborg County, Denmark. Methods: This prospective study comprised 1013 consecutive cases of ag e-related cataract; 48% of the surgeries were performed in the hospita l and 52%, at 1 of 4 clinics. Demographic and clinical data were recor ded on standardized data sheets at referral, surgery and final refract ion. Main outcome measures were change in best corrected visual acuity (BCVA), refractive power at final refraction, surgery-related complic ations, and waiting time for surgery and final refraction. Results: Th e hospital group had greater dispersion of age (P < .001) and higher f requency of general health problems (P < .005) and glaucoma (P < .01) than the clinic group. Fifty-four percent of surgeries were by phacoem ulsification and 46% by extracapsular cataract extraction (ECCE). In g eneral, phacoemulsification was prevalent at the hospital and ECCE at the clinics. No difference was found between groups in visual acuity a t final refraction. Of all patients, 87.1% attained a BCVA of 0.5 or b etter and of the best cases, 96.2%. Zonule or capsule rupture with or without vitreous loss occurred more often in the hospital group (P < . 05), while the incidence of postoperative complications was identical in the 2 groups. One case of retinal detachment was found. Time from r eferral to final refraction was shorter at clinics, while waiting time from surgery to final refraction was shorter at the hospital (P < .00 1). Conclusion: Dividing cataract surgery between hospital and private clinics seems to be a satisfactory model for meeting the increasing d emand for cataract surgery.