Global multi-site, prospective analysis of cataract surgery outcomes following ICHOM standards: the European CAT-Community

Bart LM Zijlmans, Rogier van Zijderveld, Michele Manzulli, Gonzaga Garay-Aramburu, Philipp Czapski, Nicole Eter, Raphael Diener, Josep Torras, Daniele Tognetto, Rosa Giglio, Chiara De Giacinto, Joaquin Fernandez, Clare O'Donnell, David P Piñero,

Research output: Contribution to journalArticleResearchpeer-review


PURPOSE: To evaluate in a large sample of patients from 10 different European centers the results of cataract surgery, characterizing the relationship between patient-reported outcomes (PROMs) and clinician-reported outcome measures (CROMs).

METHODS: Prospective non-interventional multicenter observational descriptive study analyzing the clinical outcomes of a total of 3799 cases undergoing cataract surgery (mean age: 72.7 years). In all cases, the cataract surgery standard developed by the International Consortium for Health Outcomes Measurements (ICHOM) was used to register the clinical data. Three-month postoperative visual acuity and refraction data were considered CROMs, whereas Rasch-calibrated item 2 (RCCQ2) and total Catquest-9SF score (CQ) were considered PROMs.

RESULTS: Postoperative corrected distance visual acuity (CDVA) was 0.3 logMAR or better in 88.7% (2505/2823) of eyes. Mean differences between preoperative and postoperative RCCQ2 and CQ scores were -3.09 and -2.39, respectively. Visual function improvement with surgery was reported by 91.5% (2163/2364) of patients. Statistically significant, although weak, correlations of postoperative CDVA with postoperative refraction, PROMs, and complications were found (0.133 ≤ r ≤0.289, p < 0.001). A predictive model (R2: 0.254) of postoperative CDVA considering 10 variables was obtained, including preoperative CDVA, different ocular comorbidities, age, gender and intraoperative complications. Likewise, another predictive model (R2: 0.148) of postoperative CQ considering a total of 14 variables was obtained, including additionally preoperative CQ, target refraction and previous surgeries.

CONCLUSIONS: Cataract surgery provides an improved functional vision in most of patients although this improvement can be limited by ocular comorbidities and complications. The relationship between PROMs and CROMs is multifactorial and complex.

Original languageEnglish
Pages (from-to)1897-1905
Number of pages9
JournalGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
Issue number7
Early online date14 Apr 2021
Publication statusPublished - Jul 2021


Dive into the research topics of 'Global multi-site, prospective analysis of cataract surgery outcomes following ICHOM standards: the European CAT-Community'. Together they form a unique fingerprint.

Cite this