Evaluation Of Key Performance Indicators For Cataract Surgery At The Royal Victoria Eye And Ear Hospital, Dublin, Ireland

This study examines the key performance indicators (KPIs) for cataract surgery at the Royal Victoria Eye and Ear Hospital, Dublin, from January 2021 to December 2024. The goal is to assess the quality, efficiency, and outcomes of cataract surgeries, identify trends, and evaluate the success of hospital protocols.

The study was conducted at the Royal Victoria Eye and Ear Hospital, Dublin, the national referral centre for ophthalmology in Ireland. 

Data was collected over a four-year period, January 2021 to December 2024, covering both pre-pandemic and pandemic periods, to assess performance trends. Data was analysed using the Medisight audit tool. Four KPIs were assessed and compared to international benchmark standards: posterior capsule rupture (PCR) rate, with and without vitreous loss <1.95%; microbiologically confirmed endophthalmitis after cataract surgery <0.04%; biometry accuracy in cataract surgery, defined as deviation from predicted spherical equivalent within one dioptre >85%; good vision after cataract surgery, defined as visual acuity ≥ 6/12, excluding ocular co-pathology >90%. 

A total of 7,677 cataract surgeries were included over the four-year period, January 2021 to December 2024. The overall PCR rate was 1.19%, which was within the international standard of <1.95%. The overall endophthalmitis rate was 0.01%, which was within the international standard of <0.04%. The overall biometry accuracy rate was 89.11%, which exceeded the international standard of >85%. The overall rate of good vision after cataract surgery was 91.66%, which exceeded the international standard of >90%. All four benchmarks were met in each year for the duration of the study period, aside from good vision after cataract surgery in 2021 (86.11%).  

To our knowledge, this is the largest audit of cataract surgery in Ireland to date. The study found a steady surgical success rate throughout the period, despite the disruptions caused by COVID-19. Surgical volume experienced fluctuations during the pandemic, but patient outcomes remained largely consistent. The analysis highlighted areas of strength, such as low complication rates, while also identifying opportunities for improvement, such as biometry accuracy. The findings provide valuable insights into the performance of cataract surgery in Ireland and serve as a foundation for ongoing quality improvement initiatives, aiming to further enhance patient care, streamline surgical processes, and optimize overall performance in the future.