Practical application of cataract risk stratification
Reviewed by Ivan Yip

This study assessed the practicability of a risk stratification system, the New Zealand Cataract Risk Stratification (NZCRS) in a major teaching hospital. The scoring system was as follows: three points for Dense cataract, pseudoexfoliation (PXF), phacodonesis, previous vitrectomy and only eye; two points for alpha antagonist; one point age >88, corneal scarring, high ametropia (>6D), posterior capsule (PC) plaque, posterior polar cataract, shallow anterior capsule (AC) (<2.5mm), small pupil (<3mm), other patient factors. If the score was greater than three, this was consultant only. These factors were modified from the Muhtaseb risk system; 621 eyes were included. Scores were calculated in 80.5% (500/621) and were adhered to in 99%. When compared to the previous phases overall intraoperative complication rate was 3.0%, which was significantly lower than 8.4% and 5.0%. PC rupture rate was only 0.8% in comparison to UK Cataract National Database figure of 1.92%. Although a different scoring system compared to the UK, this study highlights the impact a scoring system can have in reducing complications of cataract surgery.

Auckland Cataract Study IV: Practical application of NZCRS cataract risk stratification to reduce phacoemulsification complications.
Han J, Patel D, Liu K, et al.
JOURNAL OF CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
2020;47(48):311-8.