Clinical Study
Eye (2006) 20, 25–28. doi:10.1038/sj.eye.6701778; published online 29 April 2005
National Biometry Audit II
Financial interest declaration: Robert Johnston is a Director of Medisoft Limited.
This work was presented at the Royal College of Ophthalmologists Congress, Manchester 2004.
R P Gale1, N Saha2 and R L Johnston3
- 1Department of Ophthalmology, York Hospital, York, UK
- 2Department of Ophthalmology, Royal Victoria Hospital, Newcastle, UK
- 3Gloucestershire Eye Department, Cheltenham General Hospital, Sandford Road, Cheltenham, UK
Correspondence: RL Johnston, Gloucestershire Eye Department, Cheltenham General Hospital, Sandford Road, Cheltenham GL53 7AN, UK. Tel: +44 1242 272529; Fax: +44 1242 272585; E-mail: rob.johnston@egnhst.org.uk
Received 28 July 2004; Revised 21 October 2004; Accepted 21 October 2004; Published online 29 April 2005.
Abstract
Purpose
To determine the change in compliance with the Royal College of Ophthalmologists biometry guidelines since the last National Audit 2 years ago and in particular to quantify the adoption of modern methods of axial length measurement and customisation of A constants.
Method
A structured telephone questionnaire of individuals who perform biometry in all eye departments in the United Kingdom.
Results
A biometrist was interviewed in 94 of the 178 United Kingdom Ophthalmology departments. Compared with 2 years ago, nurses alone perform biometry more frequently (67 vs 51%) and junior doctors less frequently (9 vs 15%). More biometrists now attend external training courses (45 vs 37%). The Royal College of Ophthalmologists recommended intraocular lens calculation formulae (SRK-T, Hoffer Q, and Holladay) are used more commonly (30 and 15%) and audit of prediction error is being performed more freqently (78 vs 71%). The routine use of a partial coherence laser interferometry has increased from 35 to 61% in United Kingdom Ophthalmology departments. Currently, only one United Kingdom department is routinely using immersion ultrasound biometry. 'A' constants are customised in 47% of departments.
Conclusion
Over the last 2 years, there has been improved implementation of the Royal College of Ophthalmologists guidelines on biometry. It is essential that the Royal College of Ophthalmologists guidelines are updated to include current best practice of routine use of partial coherence laser interferometry or immersion biometry and customisation of A constants. A benchmark standard of 85–90% of patients achieving a final postoperative refraction within 1 dioptre of the predicted should be established.
Keywords:
cataract, biometry, IOL calculation formulae, customisation, axial length measurement, guidelines
