Sir,

I would like to thank PT Ashwin and SR Mohamed for their interest in our article on variance in posterior capsular rupture rates between surgeons and grades of surgeons. As described in the first paper in this series1: ‘The majority of the data (86%) from the 12 participating trusts were collected between January 2004 and July 2006, with no individual surgeon having performed more than 4.6% of the operations and no unit having contributed more than 20% of all operations’. The basic demographic details in this large sample of 55 567 operations and 406 surgeons were also nearly identical to the National Hospital Episode Statistics for this period. This reassures us that despite the contributing centres being at the forefront of the electronic medical record (EMR) use, their casemix is probably representative of the UK.

The same EMR system used in this study has now been adopted at more than 50 Trusts in the UK performing close to 100 000 cataract operations per annum. A National Ophthalmology Database capable of accepting pseudoanonymised data from all centres that use EMR systems is being built under the auspices of the Royal College of Ophthalmologists for the purposes of audit, revalidation and epidemiological research. If all centres agree to contribute data, we will soon be able to establish unequivocally accurate benchmark standards for the UK population.