Cataract care process: Systematic review of clinical guidelines and synthesis of recommendations

Abstract

Introduction

In 2020, 94 million people worldwide had moderate to severe visual impairment or blindness due to cataracts, particularly among older adults. The allocation of resources and appropriate strategies are essential for effective healthcare management that can control costs and improve patients’ quality of life. Clinical Practice Guidelines (CPGs) help reduce variability in care.

Objective

To analyze, compare, and synthesize recommendations from multiple guidelines on the same topic in order to identify consistencies, discrepancies, and opportunities for improvement.

Methods

Websites of international organizations, scientific societies, and various databases such as PubMed, WoS, and Cinahl were reviewed. A systematic review identified five high-quality CPGs for cataract management, with recommendations covering diagnosis, treatment, and postoperative follow-up.

Results

Although some variability was found, common recommendations were identified. Two widely agreed upon recommendations stood out: avoiding routine preoperative medical tests for local anesthesia, as they do not reduce complications, and using intracameral antibiotics (cefuroxime/moxifloxacin) for infection prevention, supported by high-level evidence, among others. The guideline developed by the American Academy of Ophthalmology – Cataract in the Adult Eye Preferred Practice Pattern – was found to be the most valid and useful.

Conclusion

Standardizing high-evidence recommendations can improve clinical decision-making, reduce variability, and enhance patient outcomes. This study highlights the need for better implementation strategies and patient-centered education to improve adherence to care.