Wednesday, December 15, 2010

Rating Cataract Surgery: The Twin Bridges Score

We introduced something called the Twin Bridges Score, a measurement of the quality of cataract surgery proposed by a very influential consultant, John Pinto. Mr. Pinto has 2+ decades of experience working in eyecare with ophthalmologists, eye surgeons just like our Dr. Darrell White. Here's a LINK to an animated video on cataract surgery to help.

The Twin Bridges study group looked at many possible quality indicators for cataract surgery in the hope that there might be a way to identify the best cataract surgeons in America. The three that they settled on take into account safety, technical ability, and accuracy/service. The safety issue is very easy to understand: what is the complication rate for an individual surgeon? Interestingly, in the original group studied the rate of surgeon-dependent complications was so low that there was no way to add it to a score. In other words, in any measurement of the top group of cataract surgeons in the United States you can't tell any difference between them on the basis of safety--they all have complication rates that are very, very low.

How well the cataract surgery goes can be determined, at least in part, by how quickly someone recovers from surgery. How quickly you see well, up to a level of vision that would at least allow you to drive a car. In most states that means 20/40 vision, and a reasonable time to look at this is one week out from the surgery. If your vision is already good here it is likely that you had well-done surgery. In fact, in the Twin Bridges group most patients had much better vision at one week.

Lastly, the accuracy of the implant power chosen is a reflection on the care that the surgeon and his or her team take in the planning and execution of the surgery. The Twin Bridges score looks at how close each patient came to the planned outcome or expected glasses prescription after the surgery. This all adds up to a score with a maximum of 100, where above 90 is where the best of the best are.

Where is Skyvision and Dr. White? Tune in...

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