Cataracts

Effective Health Care Bulletins from the Centre for Reviews and Dissemination have been featured in Bandolier before. Several have been published this year, on prevention and treatment of pressure sores, on benign prostatic hyperplasia, on management of cataracts and (imminently) on performing systematic reviews. These are all terrific reviews which should be immediately available to most of us.

Cataract NNT

The bulletin on management of cataracts has clear messages for primary and secondary health care and for patients. It tells us these things:-

Cataract surgery is highly effective - with improved levels of visual acuity in some 95% of patients. Since experience is that cataracts don't get better without treatment, this equates to a NNT of about 1.05 - a very effective treatment.
Cataract surgery is cost effective - but perhaps 20% of patients need laser treatment within two years of surgery for opacification of the posterior capsule.
Other adverse events are rare.
Day case surgery is as effective as inpatient surgery, is about 30% cheaper and acceptable to patients. Around 80% of cataract operations could be done as day cases - four times as many as now.

Effective Health Care bulletins published in 1996 include:-

Prevention and treatment of pressure sores
Benign prostatic hyperplasia
Management of cataract

They are available from Subscriptions Department, Pearson Professional, PO Box 77 Fourth Avenue, Harlow CM19 5BQ. Tel 01279 623924; Fax 01279 639609.

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