Roibeard Ó’hÉineacháinin Paris

THIS year’s ESCRS Congress report ofthe European Cataract Outcome Study(ECOS) was the largest to date anddemonstrated that the increasing adop-tion of modern surgical practices isresulting in improved visual outcomes,said Mats Lundstrom MD, the chairmanof the study.

The ECOS session at the XXIICongress of the ECSRS also providedsurgeons with an opportunity to

participate in the study online at the study’s website www.euro-cat.net.Those attending the session were invited to obtainusernames and passwords which would enable them not onlyto upload their outcome data but also to view the outcomedata of their own individual clinics.

"The online system should enable us to achieve the main pur-poses of this study more effectively, which is to provide sur-geons with a benchmark for good practice in cataract surgeryso that they can compare their results with others in an anony-mous way," Dr Lundstrom told EuroTimes.

The ECOS results include data from over 28,000 cataractprocedures carried out at a total of 72 centres in 22 Europeancountries from 1995 to 2003. During that time the number ofcountries and clinics participating annually has more than dou-bled while the number of procedures analysed has more thantrebled, rising from 1403 cases in 1995 to over 5,000 cases in2003, he noted.

The ECOS results showed that overall 77.5% of patientswere within 1.0 D of target refraction and 85% have a postop-erative visual acuity of 20/40 or better.

Moreover, the majority of eyes with worse visual acuities may

e accounted for by retinal problems like AMD, a condi-tion which was present at follow-up in 15.9%.

Dr Lundstrom’s presentation also focused on the outcomeat nine centres which have participated in the ECOS studyevery year from the very beginning.The results showed thatin those centres the adoption of small incision cataract sur-gery and foldable lenses has correlated with a significantdecrease in the mean amount of induced astigmatism

That is, in the nine centres that participated every year themean induced astigmatism fell from 0.6 D in 1995 to 0.3 Din 2003.That compared to only a small decrease in meaninduced astigmatism from 0.8 D to 0.7D among all of theparticipating centres taken as a whole.

On the other hand the difference between target andachieved refraction has not changed either overall or in thenine consistently participating centres.The mean overall dif-ference between target and achieved refraction has remainedconsistent at around 0.7 D-0.8 D. Also unchanged is the rateof sight-threatening complications which continue to occur ata rate of 3.0%-4.5%.

Dr Lundstrom told EuroTimes that by identifying suchproblems, the ECOS study can serve as an impetus to sur-geons to investigate ways of improving their surgical prac-tices.

"We would like to encourage greater participation inECOS as it enables individual surgeons to have a better ideaof what they can achieve with the possibility of raising thegeneral standard of cataract surgery."

ECOS Online

Mats Lundstrom