Jina V Han, Dipika V Patel, Bia Z Kim, Henry B Wallace, Charles NJ McGhee

Purpose: A preoperative risk stratiftcation system for phacoemulsiftcation cataract surgery speciftcally tailored for New Zealand- the NZ cataract risk strati- ftcation (NZCRS) system was recently introduced in a public teaching hospital, Auckland, New Zealand. This study aims to assess its efftcacy in reducing operative complications.
Method: Prospective observational study on
500 cases of cataract surgery performed between April and July 2017. The NZCRS system was used to calculate a preoperative risk score for each case. Depending on the score, the minimum level of sur- geon experience needed for that case was suggested
i.e. trainee registrar, fellow or consultant. All other intraoperative management remained unchanged from existing practice. The main outcome measure was intraoperative complications. Postoperative events and visual outcomes on day 1 and at 4-6 weeks were also evaluated.
Results: Preliminary data on preoperative risk scores calculated for 350 of 500 cases to date, highlighted that 39% of cataract cases were ?higher risk?, and were allocated to fellows and consultants. Subsequently, the primary surgeon was registrar 25%, fellows 19%, and consultants 56% respec- tively. To date ftve cases of adverse events have been identifted (3 iris trauma, 2 focal Descemet?s mem- brane tears), but no complications of capsular tear or vitreous loss have been reported. A full breakdown of all 500 cases will be presented with an analysis of whether this modifted NZ risk stratiftcation improves outcomes compared to 1000 recently reported cases from Auckland.
Conclusion: The NZCRS scoring system assists in identiftcation of high-risk cases and focussed surgi- cal planning. Through appropriate matching of case difftculty to surgeon experience, improvements in outcomes and safety are anticipated.