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EUREQUO and Beyond
Registry provides real-world, evidence-based knowledge to cataract and refractive surgeons. Roibeárd O’hÉineacháin reports
The European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) continues to evolve in the scope of its research and the number of its participants collecting and collating data on cataract and refractive surgery, according to Professor Mats Lundström MD, PhD.
Prof Lundström noted that EUREQUO started in 2008 as a three-year project, co-funded by the EU and ESCRS, with 11 national societies and EyeNet Sweden as associated partners. Since October 2011, the project has been funded entirely by the ESCRS. As of January 31, 2020, it has included data from 3,296,147 cataract and 150,191 refractive cases, and currently, 25 countries are participating.
“The purpose of the EUREQUO project was to improve treatment and standards of care for cataract and refractive surgery, make a significant impact on the exchange of best practices [concerning] patient safety, and develop evidence-based guidelines for cataract and refractive surgeries across Europe. Today it is also a reference database for ESCRS members,” Prof Lundström said.
He noted the many reasons for participating: As a service, it provides ESCRS members a means of benchmarking, outcome comparisons, and stimulation for improving cataract and refractive surgery. In addition, participation contributes new knowledge in the field as well as provides an opportunity for research and education.
Between 2008 and 2013, EUREQUO extended its data to include information from countries outside of Europe and added new parameters to be investigated and patient-reported outcomes. The registry’s steering committee designed and validated new questionnaires and changed its data collection system to make it more flexible.
CLINICAL RESEARCH Using its huge database, EUREQUO has published several studies regarding practice styles and outcomes in cataract and refractive surgery. They include evidence-based guidelines for cataract surgery published in 2012, a 2013 study on visual outcomes of cataract surgery, a 2015 study on the changing pattern of cataract surgery indications (which also included data from the Malaysian database), and a 2016 case-control study comparing femtosecond laser-assisted cataract surgery with standard phacoemulsification cataract surgery.
EUREQUO has also published a number of studies analysing surgical complications and outcomes in complex cases. They include a 2018 study on risk factors for refractive error after cataract surgery, a 2015 study on cataract surgery outcomes in eyes that have undergone previous corneal refractive surgery, a 2020 study on risk factors for dropped nuclei in cataract surgery, and a 2020 study on cataract surgery in eyes that have undergone previous vitrectomy.
EUREQUO is now in the process of making its system more efficient and user-friendly. One approach under consideration is a data warehouse with automated data entry. There remain several technical, ethical, and legal issues to be resolved to meet that goal. One idea under consideration is travelling algorithms, where countries collect data in a similarly structured way and use an algorithm to calculate and analyse it. The final data then enters the international database.
Prof Lundström acknowledged all participating surgeons, clinics, and patients, as well as all steering group members past and present—most especially the late Peter Barry, “who saw the light”.
This presentation was made at the 39th Congress of the ESCRS in Amsterdam.
Mats Lundström MD, PhD is the clinical director of EUREQUO and Professor of Ophthalmology at Lund University, Sweden. mats.lundstrom@med.lu.se
