Shaping The Future Of Ophthalmic Services: Evaluating A Complex Anterior Segment Service (Cass) Model For Nationwide Integration

Evaluation of a newly developed complex anterior segment service within a tertiary hospital to determine feasibility for broader adoption and implementation nationally and regionally

Tertiary Referral Eye Centre

Quantitative: A retrospective review of all secondary intraocular lens procedures performed by the  complex anterior segment service from July 2022–June 2024 which included the variable visual acuity, intraocular pressure, postoperative refraction and endothelial cell count, all at baseline and at postoperative intervals as well as return to surgery data. Quarterly clinic and surgical wait times, and patient complaint data from July 2021–June 2025, was also analysed. Qualitative: Logs of educational outputs and operational challenges were reviewed

Clinical outcomes were non-inferior or better than the majority of studies currently published. Of 178 patients, visual acuity improved in 98% of patients. Best Corrected Visual acuity was 6/12 or better in 91% of patients. 4 patients required return to surgery for complications i.e. repeat dislocation or retinal detachment. The clinic and surgical wait times were significantly reduced compared to before the service was established, from a 6 – 9 month wait time down to 14 weeks for non-urgent cases and a formalized pathway for the referral of emergency cases. As a result, patient complaints related to complex cataracts and complications post surgery dropped significantly. Operational challenges included accurate tracking of cases.

Results are promising - beyond improving clinical outcomes, the project fosters leadership in service innovation, supports training and education, and contributes to strengthening health systems. Ultimately, this work aims to shape a future-ready framework for complex anterior segment care that can be integrated across diverse healthcare settings