BMJ Open Ophthalmology
Sweden, Netherlands, Japan, India. These aren’t just the places we want to go when the COVID-19 pandemic is over, but also some of the countries with the highest per-capita numbers of cataract surgery. There are greater than 20 million cataract surgeries globally each year, and the authors of this study sought to determine the universality of cataract practice globally by creating a survey to assess preoperative measures, intraoperative practices, and postoperative care. A diverse group or respondents was represented in terms of location (38 different countries), surgical volume, and practice setting. In terms of pre-operative testing, 51.7% of surveyed institutions conducted pre-op ECG and blood testing, 60% had the ophthalmologist interview the patient, and 27% had the anesthesiologist; 6% did not ask for any pre-op testing. The type of institution (academic, private practice, vs. public) was related to differences in pre-operative care, though surgical volume was not. Intraoperatively, the type of institution influenced the number of surgeons present in the OR with private practices more likely to have surgeons operating alone. Similarly, vascular access was more frequent in public hospitals and least in private practices. A number of other differences in pre-, intra-, and post-operative care existed across countries and institution type. This global inconsistency should be addressed with cost effective solutions that can simultaneously lead to increased patient safety.