NICE Cataract guidance

Question 1

How must information be presented to patients?

Answer 1

Orallly and written and in accesible format

Question 2

Is there a visual acuity at which cataract surgery can be performed?

Answer 2

No, there is no limit

Question 3

When should ultrasound biometry be used?

Answer 3

If optical biometry is not possible or gives inaccurate measurements

Question 4

How should corneal curvature be measured?

Answer 4

Using keratometry

Question 5

When should corneal topography be used?

Answer 5

If corneas are abnormally flat or steep
Irregular corneas
Patients with significant astigmatism
People who have had prior RX surgery
When it is not possible to get an accurate K reading

Question 6

When should teh Hoffer Q formula be used?

Answer 6

axial length <22mm

Question 7

When should the Haigis formular be used?

Answer 7

axial length <22mm or greater than 26mm

Question 8

When should the Barrett Universal II formula be used?

Answer 8

axial length between 22 and 26mm

Question 9

When should the SRK/T formula be used?

Answer 9

axial length between 22 and 26 if Barrett Universal not installed and over 26mm

Question 10

How much of the first-eye prediction error should be incorporated into the second eye?

Answer 10

50%

Question 11

Should multifocal IOL’s be offered?

Answer 11

No

Question 12

what should 2 members of the team check before surgery?

Answer 12

accuracy and consistency of formulas, calculations, and IOL constants

Question 13

How many IOLs should there be in the operating room?

Answer 13

Two of the same power and a bank of other designs

Question 14

When should femto-assisted cataract surgery be offered?

Answer 14

Only as part of a randomised control trial

Question 15

What anaesthesia should be offered?

Answer 15

Sub-tenon or topical (with or without intracameral)

Question 16

What anaesthesia should not be offered?

Answer 16

Retrobulbar

Question 17

What should be considered to prevent floppy iris syndrome?

Answer 17

Intracameral phenylepherine

Question 18

When should capsular tension rings be used?

Answer 18

Only in patients with pseudoexfoliation, no-one else

Question 19

What should be injected after surgery?

Answer 19

Cefuroxime made up by pharmacy or commercially prepared

Question 20

When should NSAI’s be offered after cataract surgery?

Answer 20

Anyone with increased risk of developing CMO

Question 21

Should the patient be seen routinely the next day?

Answer 21

No