2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Tb01,As health insurers, payers, and policymakers look to Merit-Based Incentive Payment System (MIPS) measures to judge eye care quality, compare surgeon performance, and make decisions about reimbursement, it is essential to understand the validity and generalizability of these metrics. To assess the validity and generalizability of 2024 MIPS measure 191, Cataracts: 20/40 or Better Visual Acuity Within 90 Days Following Cataract Surgery. This was a retrospective cohort study of patients who underwent at least 1 cataract surgery from 2010 through 2023 at any of 16 participating health systems in the Sight Outcomes Research Collaborative (SOURCE). The study assessed whether patient demographic characteristics and nonclinical and clinical factors were associated with achieving success, which MIPS measure 191 defines as a best recorded visual acuity of at least 20/40 within 90 days following cataract surgery. Data analysis was conducted from June 2024 to December 2025. Cataract surgery. The percentage of patients undergoing cataract surgery achieving success and the odds of surgical success were determined; for patients with 2 operative eyes, only the first eye surgery was assessed. Success rates were evaluated among all surgery recipients and separately among patients with no preexisting chronic ocular diseases as specified by the metric. Success rates were quantified using more stringent cutoffs and adjusting the follow-up duration. Logistic regression models assessed how nonbiological determinants of health and clinical factors influenced the odds of success. A total of 55 132 patients underwent cataract surgery (mean [SD] age, 70.3 [9.3] years; 32 240 [58.5%] female; 1973 [3.6%] Asian American; 7053 [12.8%] Black; 1993 [3.6%] Hispanic; 42 178 [76.5%] White [race and ethnicity were self-reported]). Among all patients undergoing surgery, 49 979 (90.7%) achieved surgical success. Excluding patients with ocular comorbidities (25 563 patients [46.4%]), 28 242 of 29 569 (95.5%) achieved surgical success. Living in the least (vs most) affluent community (odds ratio [OR], 0.81; 95% CI, 0.72-0.91), undergoing complex surgery (OR, 0.82; 95% CI, 0.75-0.89) or a combination of cataract with another intraocular surgery (OR, 0.32; 95% CI, 0.29-0.35), and having diabetes (OR, 0.90; 95% CI, 0.84-0.98) were associated with lower odds of surgical success. In this cohort study, most patients undergoing cataract surgery achieved success as defined by MIPS measure 191; however, the existing measure excluded nearly half of patients undergoing surgery, and older patients and Black patients were more likely to be excluded. Case-mix adjustment of patients' sociodemographic characteristics and clinical factors may be necessary to ensure fairness when comparing surgeons' performance.31:Tfd5, Importance As health insurers, payers, and policymakers look to Merit-Based Incentive Payment System (MIPS) measures to judge eye care quality, compare surgeon performance, and make decisions about reimbursement, it is essential to understand the validity and generalizability of these metrics. Objective To assess the validity and generalizability of 2024 MIPS measure 191, Cataracts: 20/40 or Better Visual Acuity Within 90 Days Following Cataract Surgery. Design, Setting, Participants This was a retrospective cohort study of patients who underwent at least 1 cataract surgery from 2010 through 2023 at any of 16 participating health systems in the Sight Outcomes Research Collaborative (SOURCE). The study assessed whether patient demographic characteristics and nonclinical and clinical factors were associated with achieving success, which MIPS measure 191 defines as a best recorded visual acuity of at least 20/40 within 90 days following cataract surgery. Data analysis was conducted from June 2024 to December 2025. Exposures Cataract surgery. Main Outcomes and Measures The percentage of patients undergoing cataract surgery achieving success and the odds of surgical success were determined; for patients with 2 operative eyes, only the first eye surgery was assessed. Success rates were evaluated among all surgery recipients and separately among patients with no preexisting chronic ocular diseases as specified by the metric. Success rates were quantified using more stringent cutoffs and adjusting the follow-up duration. Logistic regression models assessed how nonbiological determinants of health and clinical factors influenced the odds of success. Results A total of 55 132 patients underwent cataract surgery (mean [SD] age, 70.3 [9.3] years; 32 240 [58.5%] female; 1973 [3.6%] Asian American; 7053 [12.8%] Black; 1993 [3.6%] Hispanic; 42 178 [76.5%] White [race and ethnicity were self-reported]). Among all patients undergoing surgery, 49 979 (90.7%) achieved surgical success. Excluding patients with ocular comorbidities (25 563 patients [46.4%]), 28 242 of 29 569 (95.5%) achieved surgical success. Living in the least (vs most) affluent community (odds ratio [OR], 0.81; 95% CI, 0.72-0.91), undergoing complex surgery (OR, 0.82; 95% CI, 0.75-0.89) or a combination of cataract with another intraocular surgery (OR, 0.32; 95% CI, 0.29-0.35), and having diabetes (OR, 0.90; 95% CI, 0.84-0.98) were associated with lower odds of surgical success. Conclusions and Relevance In this cohort study, most patients undergoing cataract surgery achieved success as defined by MIPS measure 191; however, the existing measure excluded nearly half of patients undergoing surgery, and older patients and Black patients were more likely to be excluded. Case-mix adjustment of patients’ sociodemographic characteristics and clinical factors may be necessary to ensure fairness when comparing surgeons’ performance. 32:T687,The corneal triple procedure, combining keratoplasty, cataract extraction, and intraocular lens implantation, remains a valuable option for patients with concurrent corneal opacity and cataract. We synthesize historical and contemporary evidence on penetrating keratoplasty (PKP), anterior lamellar keratoplasty (ALK), and endothelial keratoplasty (EK) triple procedures, highlighting their indications, surgical techniques, outcomes, and evolving trends. PKP triple is indicated for full-thickness scarring, keratoconus with central scarring, and cases with anterior segment abnormalities, but remains technically demanding due to open-sky cataract surgery and postoperative refractive unpredictability. ALK triple offers tectonic and visual rehabilitation in stromal disorders sparing the endothelium, though technically challenging. EK triple procedures, particularly Descemet stripping automated endothelial keratoplasty and Descemet membrane endothelial keratoplasty, are increasingly preferred in endothelial disorders such as Fuchs endothelial corneal dystrophy, offering faster recovery, more predictable refraction, and better graft survival. Advances in capsulotomy, nucleus management, intraocular lens power calculation, and perioperative strategies have improved safety and refractive outcomes across triple procedures. Long-term studies reveal that although visual and anatomical success rates remain high, complications such as graft rejection, glaucoma, and posterior capsular opacification persist. Careful patient selection and tailored surgical planning are essential, as triple procedures continue to evolve toward safer and more predictable outcomes.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Cataract Surgery: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Cataract Surgery (modality). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/modality/Cataract%20Surgery\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Modalities\",\"item\":\"https://www.reachrx.ai/hub/tag/modality\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Cataract Surgery\",\"item\":\"https://www.reachrx.ai/hub/tag/modality/Cataract%20Surgery\"}]}}"}}]],["$","$L2f",null,{"title":"Cataract Surgery: Research & Clinical Takeaways","description":"Review evidence by treatment modality: Cataract Surgery — concise summaries and practical next steps.","papers":[{"doi":"10.1016/j.apjo.2026.100322","pmid":"42044747","title":"International consensuses and guidelines on clinical management of highly myopic cataracts: A two-round modified e-Delphi study by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO) and the Asia-Pacific Myopia Society (APMS)","journal_title":"Asia-Pacific Journal of Ophthalmology","journal_issn":"2162-0989","published_at":"2026-04-25T00:00:00.000Z","url":"https://doi.org/10.1016/j.apjo.2026.100322","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:49:42.040Z","updated_at":"2026-05-07T22:49:42.040Z","tags":[{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"condition","value":"Highly Myopic Cataract","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"condition","value":"High Myopia","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"modality","value":"Cataract Surgery","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"modality","value":"Intraocular Lens Implantation","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"sample_size","value":"n=30","value_numeric":30},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"study_design","value":"Delphi Consensus Study","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"warning","value":"Sex distribution of the expert panel was not reported in the abstract; 'mixed' is assumed based on international panel composition.","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"warning","value":"The paper is dated April 2026 but was processed on May 7, 2026 — confirmed within expected publication window.","value_numeric":null},{"paper_doi":"10.1016/j.apjo.2026.100322","tag_type":"warning","value":"The study design is a modified e-Delphi (expert consensus), not a clinical trial — level of evidence is inherently limited to expert opinion. Impact flag 'practice_changing' reflects the establishment of formal international consensus guidelines where none previously existed, not superiority trial data.","value_numeric":null}],"summaries":{"what_studied":"A two-round modified e-Delphi study by 30 international cataract experts from 14 countries/territories evaluated best practices for diagnosing and managing highly myopic cataracts (HMC), covering preoperative evaluation, surgical considerations, and postoperative care.","key_result":"Consensus (≥75% agreement) was reached on endorsing HMC as a distinct disease category (86.67%), use of combined IOL formula calculations (96.67%), preference for hydrophobic acrylic IOLs (96.67%), and mandatory 3-month postoperative retinal exams (96.67%). No consensus was reached on immediate sequential bilateral cataract surgery, routine prophylactic capsular tension ring implantation, or postoperative steroid regimen.","limitations":"Consensus reflects expert opinion only, not randomized trial evidence; panel limited to 30 experts, which may not fully represent global practice variation; the modified Delphi format cannot resolve equipoise where genuine clinical controversy exists.","practice_takeaway":"For highly myopic cataracts, use combined IOL power calculation formulas and favor hydrophobic acrylic IOLs. Schedule retinal exams at 3 months postoperatively as a minimum standard, and treat HMC as a clinically distinct entity requiring tailored surgical planning."}},{"doi":"10.1001/jamaophthalmol.2026.0845","pmid":"41989790","title":"Evaluating Metrics Assessing Surgical Success in Patients Undergoing Cataract Surgery","journal_title":"JAMA Ophthalmology","journal_issn":"2168-6165","published_at":"2026-04-17T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13087895/","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-19","doi":"10.1001/jamaophthalmol.2026.0845","days":"30","issn":"2168-6165","rank":"8","field":"Clinical Medicine","score":"19","category":"Ophthalmology","categories":["Ophthalmology"],"_categories":["Ophthalmology"]},"pubmed":{"doi":"10.1001/jamaophthalmol.2026.0845","title":"Evaluating Metrics Assessing Surgical Success in Patients Undergoing Cataract Surgery.","journal":"JAMA ophthalmology","methods":"","results":"A total of 55 132 patients underwent cataract surgery (mean [SD] age, 70.3 [9.3] years; 32 240 [58.5%] female; 1973 [3.6%] Asian American; 7053 [12.8%] Black; 1993 [3.6%] Hispanic; 42 178 [76.5%] White [race and ethnicity were self-reported]). Among all patients undergoing surgery, 49 979 (90.7%) achieved surgical success. Excluding patients with ocular comorbidities (25 563 patients [46.4%]), 28 242 of 29 569 (95.5%) achieved surgical success. Living in the least (vs most) affluent community (odds ratio [OR], 0.81; 95% CI, 0.72-0.91), undergoing complex surgery (OR, 0.82; 95% CI, 0.75-0.89) or a combination of cataract with another intraocular surgery (OR, 0.32; 95% CI, 0.29-0.35), and having diabetes (OR, 0.90; 95% CI, 0.84-0.98) were associated with lower odds of surgical success.","abstract":"$30","keywords":[],"pubmed_id":"41989790","conclusions":"","publication_date":"2026-04-17T00:00:00"},"crossref":{"DOI":"10.1001/jamaophthalmol.2026.0845","URL":"https://doi.org/10.1001/jamaophthalmol.2026.0845","ISSN":["2168-6165"],"link":[{"URL":"https://jamanetwork.com/journals/jamaophthalmology/articlepdf/2847385/jamaophthalmology_li_2026_oi_260017_1774891324.70911.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Evaluating Metrics Assessing Surgical Success in Patients Undergoing Cataract 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However, 46.4% of patients were excluded by the metric due to ocular comorbidities—with older and Black patients disproportionately excluded. Lower community affluence (OR 0.81), complex surgery (OR 0.82), combined cataract+intraocular surgery (OR 0.32), and diabetes (OR 0.90) were each independently associated with lower odds of success.","limitations":"- Single metric focus (MIPS 191) limits generalizability to other quality measures.\n- Retrospective design with data from a collaborative registry may not reflect all practice settings.\n- Only the first operative eye was assessed for patients with bilateral surgery, potentially underrepresenting outcomes.","practice_takeaway":"Nearly half of cataract surgery patients are excluded from MIPS measure 191 due to ocular comorbidities, and older and Black patients are excluded at higher rates—raising fairness concerns when this metric is used for surgeon comparisons or reimbursement. 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Heterogeneity across PKP, ALK, and EK indications and techniques limits direct comparison.","practice_takeaway":"Favor EK triple in endothelial disorders to improve recovery speed, refractive predictability, and graft survival; use PKP triple for full‑thickness scarring or complex anterior segment issues, and ALK triple for stromal disease with intact endothelium. Careful patient selection and tailored surgical planning are key to reduce risks such as rejection, glaucoma, and posterior capsular opacification."}}],"initialOffset":3,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Cataract Surgery"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Cataract Surgery"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Cataract Surgery"}}}]]

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