Accurate Preoperative Cataract Clinical Assessment: Vital Step For A Successful Surgery And Effective Training

To evaluate the accuracy of assessing and documenting the important aspects of any cataract case that will affect the preoperative preparation and success of the surgery. This is to increase the quality of our clinical assessment and have better surgical planning to avoid surprises on the day of the surgery, especially in a training environment. 

Cataract surgeries performed during April 2023 in Northern General Eye Centre, Sheffield Teaching Hospitals NHS Foundation Trust. 

A retrospective analysis of all the cataract surgeries performed during April 2023 and their preceding clinical assessments. We concentrated on the comments entered on three aspects: - cataract density, adequacy of pupil dilation, and anterior chamber depth. 

In April 2023, a total of 179 eyes had cataract surgery. Generally, there was an appropriate assessment and documentation across the three studied aspects. The size of the dilated pupil was documented in 153 eyes. Only 31 eyes had discrepancies in pupil size assessment between that in the clinic and on the day of surgery. Thirteen eyes needed pupil expansion either mechanically or pharmacologically. On the other hand, clinical assessment suggested that 19 eyes would need vision blue, but it was used only in 4 of them. All eyes (except one) with shallow anterior chamber clinically received preoperative IV mannitol. 

A good assessment of the degree of cataract density, degree of pupil dilation, and anterior chamber depth is important in evaluating cataract cases. This will facilitate proper preoperative surgical planning and allocating cases according to the surgeon's experience and training needs. 

There are no financial conflicts of interest to disclose.