Institutional comparison of methods of intraoperative cataract surgery complication reporting

This study evaluated the effectiveness of surgeon self-reporting and anterior vitrector equipment billing in identifying intraoperative posterior capsular tears (PCT) with vitreous loss during cataract surgery. A total of 19,258 cataract surgeries performed over six years at the John A. Moran Eye Center were analyzed, with 343 potential complications identified through billing or self-reporting, and 193 confirmed PCT cases based on chart review. Billing data captured 83.9% of PCTs but lacked specificity, including many non-PCT uses of anterior vitrectomy. Surgeon self-reporting was highly specific, with 100% accuracy according to operative reports, but detected only 58.5% of total PCT cases. The findings highlight the strengths and limitations of both methods—billing is sensitive but overinclusive, while self-reporting is accurate but underutilized. Neither method alone was sufficient to identify all complications, emphasizing the need for a standardized, comprehensive approach to intraoperative complication monitoring to enhance patient safety and quality assurance in ophthalmic surgery.