1. Epidemiology of cataract Surgery in Israel: 1990-2009 Guy Kleinmann, MD 1 Eli Rosen, MD 2 Ehud I Assia, MD 2 1. Ophthalmology Department, Kaplan Medical Center 2. Ophthalmology Department, Meir Medical Center No financial disclosure

2. Purpose To present the epidemiology of cataract surgeries in Israel during the last 20 years; 1990-2009

3. Methods  Since 1990 questionnaires were sent to all the surgery center in sent to all the surgery center in Israel Israel  The questionnaires evolved during those years during those years  The response increased from 75% at the early years to 100% 75% at the early years to 100% at recent years at recent years

4. Results  A total of 517,415 cataract surgeries were reported during this period cataract surgeries were reported during this period  The annual surgery number increased from 16,841 to 49,284 surgeries Annual surgery number (6.6 surgeries per 1000 people)

5. A shift from the university affiliated Hospitals to the ambulatory surgery centers: 1999 – 66% of the surgeries were done in the university hospitals in the university hospitals 2009 – 51.5% of the surgeries were done in the university hospitals in the university hospitals Results – cont.

6. Surgery technique: From manual (56%, 1999) to Phaco (96%, 2009) Results – cont.

7. From rigid IOLs to foldable IOLs 2009: Rigid – 5% Foldable – 95% Hydrophilic – 61.5% Hydrophobic – 38.5%

8. Results – cont. From retrobulbar to topical anesthesia 2009:

9. Results – cont. Endophthalmitis Israel is a “closed system” all cases: were operated in Israel stayed in Israel during the endophthalmitis were treated in the university hospitals A decrease in the endophthalmitis rate: From 0.24% (2000) to 0.05% (2009)

10. Results – cont. Intracameral antibiotic injection at the end of surgery: Wide acceptation since 2006 (94% at 2009) Since 2006 worse VA results of endophthalmitis cases

11. Conclusion During the last 20 years we found:  Continuous increase in cataract surgeries annual number surgeries annual number  Progression in cataract surgery technique technique  Decrease in the severe complication rate (i.e. endophthalmitis) rate (i.e. endophthalmitis)