Murphy's Law in cataract surgeries: A retrospective analysis

Abstract

Objective

Around 400,000 cataract operations are performed annually in the UK, with a complication rate of 1.95% and the associated financial costs at over £13 million. Cataract operations are occasionally cancelled when patients cannot attend. To fully utilize theatre time, agreeable patients may be directly sent for surgery from assessment clinics. This study investigates the validity of “Murphy's Law” in ophthalmology, namely, whether there is an increase in complication rates amongst these ‘add-on’ cases.

Design & Participants

Retrospective study to compare data of add-on phacoemulsification operations against the departmental baseline.

Methods

Chi-square test was used to determine whether the complication rates differed significantly. 1-sided p-value of <0.05 was considered to be significant.

Results

227 ‘add-on’ cases were identified, of which 3 complications occurred. Departmental baseline of 4289 operations resulted in 44 complications. These represented complication rates of 1.32% and 1.03%, respectively. The level of surgical difficulty between the two groups were comparable. Statistical comparison of these complication rates demonstrated a p-value of 0.67, indicating that Murphy's Law is not significant.

Conclusions

This is the first study of its kind to examine the rates of adverse outcomes in unscheduled ‘add-on’ cataract surgeries, a commonly deployed method to maximize eye theatre time usage. Our data suggested no significant difference in complication rates between the add-on operations and local baseline. Thus, we demonstrated that the practice of same day proceeding from pre-operative assessment clinic to the operating table is a safe option to optimize theatre time use, should a surgery cancellation arise.