Comparing the rate of cataract surgery complications between a hospital and an independent health facility.

Objective: To compare the perioperative complication rates of cataract surgeries performed at a hospital and an independent health facility (IHF) in Ontario following governmental funding changes affecting for-profit private clinics.

Design: Retrospective chart review.

Participants: All patients receiving publicly funded elective cataract surgery in Kingston, Ontario, between January 1, 2023, and December 31, 2023.

Methods: Electronic medical records were assessed for 3 cataract surgery complications: posterior capsular rupture (PCR), retinal tear/detachment, and endophthalmitis. Age, eye, lens type (spheric, aspheric, premium), intraoperative complication, and postoperative complications were recorded for each chart. Differences between clinical settings were evaluated using Fisher's Exact and χ² tests (p < 0.05).

Results: A total of 3190 (hospital: 1741; IHF: 1449) charts were reviewed. The hospital had a significantly higher rate of PCRs (1.44% vs 0.21%; p < 0.01). Retinal tears/detachments occurred in 5 hospital cases (0.29%) and none at the IHF, while 2 endophthalmitis cases were reported at the IHF (0.14%) and none at the hospital (both p > 0.05). Lens use patterns significantly differed, with more premium and aspheric lenses used at the IHF and more spheric lenses at the hospital.

Conclusions: Complication rates at both sites were similar and within expected ranges. Differences in PCR rates may be explained by a tendency to perform more complicated surgeries at the hospital. The findings suggest that cataract surgery at both clinical settings is safe.