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Slim chance of cataract surgery going wrong here

Voluntary study by MOH shows 95-100% success and safety rates at four centres

BY SALMA KHALIK

Health Correspondent

The Straits Times Article "Slim Chance of Cataract Surgery Going Wrong Here" on low risk of cataract surgery

THE chances of a cataract surgery going badly wrong here are pretty slim, going by data released by the Health Ministry yesterday.

Four medical centres, Which handle two-thirds of the more than 23,000 cataract surgeries done each year, had success and safety rates ranging from 95 to 100 per cent, but the doctor behind the top-rated centre cautions against reading too much into such numbers.

The Health Ministry study excluded two major centres - at the National University Hospital and Alexandra Hospital, both of which

perform over 1,000 cataract operations a year - as they were unable to provide their data in time.

As this was a voluntary study, only one private clinic took part. The private sector performs about 5,000 cataract operations a year.

Cataract surgery becomes necessary aspeople age and the natural lens in their eyes clouds over, affecting their sight.

The 30-minute surgery replaces the cloudy lens with an artificial one, resulting in much clearer vision. It is done as day surgery, with the patient awake throughout.

Safety is breached if a patient suffers from complications such as an infection. The top-rated Jerry Tan Eye Surgery, the only private centre among the four, Was the only one that scored 100 per cent for safety. It recorded a success rate of 99.5 per cent for its 203 cases.

But it was also the most expensive. It charges between $4,200 and $4,600 per eye. Dr Jerry Tan explained that this is partly due to the private room patients enjoy at Gleneagles Hospital, where he operates, and the senior anaesthetist in attendance.

The Singapore National Eye Centre (SNEC) had the next best success rate of 98.5 per cent, and a safety rate of 97.9 per cent. It charges $2,300 to $2,900 per eye. Subsidised patients pay about $1,000.

Tan Tock Seng Hospital (TTSH) had a success rate of 98.5 per cent and Changi General Hospital scored 96 per cent.

Dr Tan said the comparisons were not really fair, as the public institutes act as training centres and have junior doctors. Experienced doctors at the public me ical institutes Would likely have similar success and safety rates.

"lf you compare my results with those of Dr Ang Chong Lye (of SNEC) or Dr Lim Tock Han (of TTSH), I'm sure theirs will be just as good," he said.

An SNEC spokesman said that of its 68 doctors Who perform cataract operations, 16 are trainees.

Dr Tan also doesn't like "playing the numbers game" and thinks a better way is to assess performance in bands instead of exact percentages: "The difference of a fraction of a per cent has little significance."

Cases Cost Success Safety
Singapore National Eye Centre 10,013 $2,300-$2,900 98.53% 97.92%
Tan Tock Seng Hospital 4,575 $2,300-$2,855 98.47% 99.49%
Changi General Hospital 1,519 $2,582-$2,905 95.98% 98.54%
Jerry Tan Eye Surgery 203 $4,200-$4,600 99.47% 100%

NOTE: CGH surgery done by SNEC doctors. Data is for 2004.

This is the second time the ministry has released comparative success rates for medical treatment.

The first, for in-vitro fertilisation (IVF) treatment, came out in 2004. Another, comparing outcomes of Lasik, or laser surgery to correct short-sightedness, is expected later this year.

The surveys are part of an MOH effort to assess the level of service, costs and success rates in specific medical clusters and help consumers make better choices. Health Minister Khaw Boon Wan said he hoped, over time, to draw in all medical institutions into the health surveys."

"I think treat it as a first step, because you cannot achieve overnight a major change like this, so step by step," he said.

"So the first step is: Let's make it voluntary... of course voluntary means for public hospitals - all of us are in. Then slowly, we hope, in a few years' time, we'll get more players also wanting to contribute and join in," he told reporters after the completion ceremony for the Rajah Court Interim Upgrading Programme at Jalan Rajah, in Balestier, yesterday.

Mr Khaw said consumers may eventually demand that all medical institutions join the survey.

"If they see, 'All right, now that I know, if I go for cataract surgery at public hospitals, this is the outcome. If I go to private hospitals, I want to know what is the outcome. And I want to ask how come the private hospitals are not joiníng this effort.' "I think, over time, more will come forward."

Source: Straits Times© Singapore Press Holdings Limited. Reproduced with permission.

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