ABSTRACT
To provide objective evidence on the transition of cataract surgical care at Farabi Eye Hospital, Iran. Two separate years, 2003 and 2006, were selected for evaluation. One thousand nine hundred fifty-seven surgical records of age-related cataract cases were randomly selected and reviewed. Three hundred fifty-three patients [405 eyes] in 2006 and 125 patients [153 eyes] in 2003 were selected randomly for a follow-up examination. The two phases were compared in terms of surgical routines, patient characteristics and outcomes for statistical differences. P <0.05 was considered statistically significant. The phacoemulsification rate increased from 25% to greater than 90% between 2003 and 2006, rates of corneal incisions and use of foldable intraocular lenses tripled, administration of general anesthesia dropped from 80% to 12%, the outpatient admission rate rose from 5.2% to 71%, 4% vs. 66% of the operations were performed by a senior phacoemulsification surgeon and the number of advanced surgeons changed from 6% to 38% [all P-values < 0.001]. In 2006, more patients at the two extremes of age, more patients with poor systemic conditions and myopes underwent surgery [all P-values < 0.05]; the cataract surgery volume increased by 49% and post-operative visual acuity improved [P= 0.03] while patient satisfaction was unchanged. We objectively documented the transition in cataract surgery technique to phacoemulsification at the Farabi Eye Hospital in the mid-2000s. This was accompanied by significant expansion of the spectrum of cataract surgery candidates and remarkable attainment of surgical skill