Using the West Midlands CONCERT to characterise regional incidence of acute-onset post cataract surgery endophthalmitis
Author:
Moussa George, Bhatt Hetvi, Reekie IanORCID, Butt GibranORCID, Ng Aaron, Blanch RichardORCID, Fusi-Rubiano William, Al-Ibrahim Jalil, Quinlan Michael, Virdee Jasvir, Dawson Sarah, Patel Amit, Low Liying, Mushtaq Fizza, Nambiar Seena, Routledge Claire, Yang Yit, Barry Robert J., Burdon Michael, Barua Ankur, De Silva Ian, Panthagani Jesse, Qureshi Madyan, Pherwani Anupama, Sigona Mark, Morphis George, Rauz Saaeha,
Abstract
Abstract
Background
Whilst research and innovation is embedded within the UK’s National Health Service (NHS) constitution, Doctors-in-training have little opportunity to contribute to designing, leading and recruiting into clinical trials or cohort studies. We formed the West MidlandsCollaborativeOphthalmologyNetwork forClinicalEffectiveness &Research byTrainees (The West Midlands CONCERT) and undertook a characterisation of post cataract surgery endophthalmitis as a proof-of-concept study to test the feasibility of the CONCERT model.
Methods
Doctors-in-training formed a collaborative working group to test the concept of delivering a pan-regional clinical effectiveness study across multiple hospital sites by performing retrospective analyses of post cataract endophthalmitis over a 6-year period.
Results
Overall, 157,653 cataract surgeries were performed by participating centres accredited to deliver the Royal College of Ophthalmologists training curriculum. Thirty-eight cases of post cataract endophthalmitis were identified, giving an incidence of 2.41 per 10,000 cases (0.0241%). A further 15 endophthalmitis cases presented who had surgery in non-training centres, giving a total of 53 cases. The most common organisms were S. epidermidis (14 (51.9%)) and P. aeruginosa (5 (18.5%)). Anterior-chamber and vitreous sampling yielded positive culture in 33.3% (6/18) and 50.9% (27/53), respectively. At 6 months follow-up, 19 (51.4%) patients achieved visual acuities of ≤0.5 LogMAR. Repeat intravitreal injections (11 (20.8%)) and vitrectomy (n = 22 (41.5%)) were not associated with better outcomes.
Conclusions
Using post cataract endophthalmitis as a pilot cohort, this study highlights the feasibility of using the CONCERT model for studies across multiple sites. A UK-CONCERT could provide a powerful infrastructure enabling characterisation of patient cohorts and a platform for high-quality interventional studies, improving patient care.
Publisher
Springer Science and Business Media LLC
Reference44 articles.
1. Health Education England. Developing a flexible workforce that embraces research and innovation, Research and Innovation Strategy; 2016. Available at: https://www.hee.nhs.uk/sites/default/files/documents/HEE%20research%20and%20innovation%20strategy.pdf. Accessed May 1, 2020. 2. RCOphth. RCOphth Workforce Census 2018; 2018. Available at: https://www.rcophth.ac.uk/wp-content/uploads/2019/02/RCOphth-Workforce-Census-2018.pdf. 3. Pinkney TD, Bartlett DC, Hawkins W, Mak T, Youssef H, Futaba K, et al. Reduction of surgical site infection using a novel intervention (ROSSINI): study protocol for a randomised controlled trial. Trials. 2011;12:217. https://doi.org/10.1186/1745-6215-12-217. 4. NHS PNTC. Peninsula NHS Treatment Centre. Available at: http://www.peninsulatreatmentcentre.nhs.uk/news/nice-guidance-on-cataracts-base-it-on-patient-need-not-eye-tests/. Accessed May 5, 2019. 5. Taban M, Behrens A, Newcomb RL, Nobe MY, Saedi G, Sweet PM, et al. Acute endophthalmitis following cataract surgery: a systematic review of the literature. Arch Ophthalmol. 2005;123:613–20.
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