A comparison of cataract surgical practices in Canada and the United States

Abstract Objective To determine cataract surgical practices in Canada and the United States. Design Cross-sectional study. Participants 1250 clinician members of the Canadian Ophthalmological Society and U.S. state societies. Methods This survey updated and expanded upon results of a 5-state survey published in 2006. Practices for the preceding 3 years were determined for the phacoemulsification machine, the ultrasound modality, the surgical approach, the viscoelastic, and the wound size used during cataract surgery. Results The participating surgeons responded concerning 963,543 surgeries. Canada had the busiest surgeons, who were more likely than their U.S. counterparts to use vertical chop and DisCoVisc. Surgeons above the median in surgical volume were more likely to use ultrapulse ultrasound, less likely to use a divide-and-conquer approach, and more likely to use a vertical chopping approach than were those below the median. The northeastern United States had the least busy surgeons. OZil is the most common ultrasound modality used today. Conclusions This expanded survey revealed that practice patterns vary quite widely. Furthermore, the preponderance of OZil ultrasound since the 2006 survey shows that changes in the field can happen very rapidly.