![](media/image1.png){width="5.96875in" height="0.41944444444444445in"}

Top of Form

## Complete Summary

#### GUIDELINE TITLE

Cataract in the adult eye.

#### BIBLIOGRAPHIC SOURCE(S)

Cataract in the adult eye. Preferred practice pattern. In: American
Academy of Ophthalmology (AAO). San Francisco (CA): American Academy of
Ophthalmology (AAO); 2006. p. 69. \[585 references\]

#### GUIDELINE STATUS

This is the current release of the guideline.

This guideline updates a previous version: American Academy of
Ophthalmology (AAO), Anterior Segment Panel. Cataract in the adult eye.
San Francisco (CA): American Academy of Ophthalmology (AAO); 2001. 62 p.

All Preferred Practice Patterns are reviewed by their parent panel
annually or earlier if developments warrant and updated accordingly. To
ensure that all Preferred Practice Patterns are current, each is valid
for 5 years from the \"approved by\" date unless superseded by a
revision.

### COMPLETE SUMMARY CONTENT

 SCOPE\
 METHODOLOGY - including Rating Scheme and Cost Analysis\
 RECOMMENDATIONS\
 EVIDENCE SUPPORTING THE RECOMMENDATIONS\
 BENEFITS/HARMS OF IMPLEMENTING THE GUIDELINE RECOMMENDATIONS\
 CONTRAINDICATIONS\
 QUALIFYING STATEMENTS\
 IMPLEMENTATION OF THE GUIDELINE\
 INSTITUTE OF MEDICINE (IOM) NATIONAL HEALTHCARE QUALITY REPORT
CATEGORIES\
 IDENTIFYING INFORMATION AND AVAILABILITY\
 DISCLAIMER

### SCOPE

#### DISEASE/CONDITION(S)

Cataract in the adult eye

#### GUIDELINE CATEGORY

Diagnosis\
Evaluation\
Management\
Treatment

#### CLINICAL SPECIALTY

Ophthalmology

#### INTENDED USERS

Health Plans\
Physicians

#### GUIDELINE OBJECTIVE(S)

To improve functional vision and the quality of life for a patient with
a cataract by addressing the following goals:

-   Identify the presence and characteristics of cataract

-   Assess the impact of the cataract on the patient\'s visual and
    functional status and on quality of life

-   Inform the patient about the impact of a cataract on vision,
    functional activity and natural history, as well as the benefits and
    risks of surgical and nonsurgical alternatives so that the patient
    can make an informed decision about treatment options

-   Establish criteria for a successful treatment outcome with the
    patient

-   Perform surgery when there is the expectation that it will benefit
    the patient\'s function and when the patient elects this option

-   Provide necessary postoperative care, rehabilitation, and treatment
    of any complications

-   Perform surgery when indicated for management of coexistent ocular
    disease

#### TARGET POPULATION

Adults (18 years and older) with cataracts

#### INTERVENTIONS AND PRACTICES CONSIDERED

1.  Diagnosis by evaluation of visual impairment, ophthalmic evaluation,
    and supplemental preoperative ophthalmic testing, as appropriate

2.  Nonsurgical management, such as educating patients about the
    benefits of smoking cessation, use of ultraviolet (UV) B blocking
    sunglasses

3.  Surgical management of cataracts, including: selection of
    appropriate candidates for surgery; preoperative medical evaluation;
    patient counseling regarding costs, risks, benefits, expected
    outcomes of surgery and care planning; discussion of anesthesia
    techniques and effects with patient; infection prophylaxis (5%
    solution of povidone iodine); selection of appropriate surgical
    technique (small-incision surgery preferred); intraocular lens
    implantation (monovision and multifocal); postoperative care, such
    as managing complications, discharge, medications, follow-up and
    examination, counseling and referral

4.  Surgical management, as indicated, for co-existent ocular disease

5.  Neodymium:Yttrium-Aluminum Garnet (Nd:YAG) laser capsulotomy for
    management of Post-Capsular Opacification (PCO)

#### MAJOR OUTCOMES CONSIDERED

-   Risk factors of cataract development

-   Improvement in visual function

-   Improvement in the quality of life

-   Utilization of cataract surgery

-   Adverse events associated with treatment

### METHODOLOGY

#### METHODS USED TO COLLECT/SELECT EVIDENCE

Searches of Electronic Databases

#### DESCRIPTION OF METHODS USED TO COLLECT/SELECT THE EVIDENCE

In the process of revising this document, a detailed literature search
of articles in the English language was conducted on the subject of
cataract for the years 2000 to August 2005.

#### NUMBER OF SOURCE DOCUMENTS

Not stated

#### METHODS USED TO ASSESS THE QUALITY AND STRENGTH OF THE EVIDENCE

Weighting According to a Rating Scheme (Scheme Given)

#### RATING SCHEME FOR THE STRENGTH OF THE EVIDENCE

I.  Level I includes evidence obtained from at least one properly
    conducted, well-designed randomized controlled trial. It could
    include meta-analysis of randomized controlled trials.

II. Level II includes evidence obtained from the following:

    -   Well-designed controlled trials without randomization

    -   Well-designed cohort or case-control analytic studies,
        preferably from more than one center

    -   Multiple-time series with or without the intervention

III. Level III includes evidence obtained from one of the following:

     -   Descriptive studies

     -   Case reports

     -   Reports of expert committees/organizations (e.g., Preferred
         Practice Pattern (PPP) panel consensus with peer review)

#### METHODS USED TO ANALYZE THE EVIDENCE

Systematic Review

#### DESCRIPTION OF THE METHODS USED TO ANALYZE THE EVIDENCE

Not stated

#### METHODS USED TO FORMULATE THE RECOMMENDATIONS

Expert Consensus

#### DESCRIPTION OF METHODS USED TO FORMULATE THE RECOMMENDATIONS

The results of the literature search on the subject of cataract were
reviewed by the Cataract and Anterior Segment Panel and used to prepare
the recommendations, which they rated in two ways. The panel first rated
each recommendation according to its importance to the care process.
This \"importance to the care process\" rating represents care that the
panel thought would improve the quality of the patient\'s care in a
meaningful way. The panel also rated each recommendation on the strength
of the evidence in the available literature to support the
recommendation made.

#### RATING SCHEME FOR THE STRENGTH OF THE RECOMMENDATIONS

**Ratings of Importance to Care Process**

Level A, defined as most important\
Level B, defined as moderately important\
Level C, defined as relevant but not critical

#### COST ANALYSIS

In a study in Sweden and a study in the United States, the hypothetical
cost per quality-adjusted life year (QALY) gained for cataract
extraction in one eye was estimated respectively at US \$4,500 and US
\$2,023. In a US study, the estimated cost per QALY gained for cataract
surgery in the second eye was US \$2,727 (calculated in 2003). These
values for cataract surgery compare favorably with those reported for
other ophthalmic procedures (e.g., laser photocoagulation for diabetic
macular edema, \$3,101; laser photocoagulation for extrafoveal choroidal
neovascularization, \$23,640).

A review of technological innovation looked at the costs and benefits of
several treatments for disease conditions, including heart attack, low
birthweight infants, depression, breast cancer, and cataracts. The
authors concluded that expansion in treatment for patients operated at
much less severe measures of visual acuity than in the past is almost
certainly beneficial and that there have been substantial improvements
in quality at no cost increase per patient. The present value of
cataract surgery was estimated at \$95,000, which is much greater than
the estimated costs of \$2,000 to \$3,000. Thus, the benefits of
expanded cataract treatment exceed the costs.

#### METHOD OF GUIDELINE VALIDATION

External Peer Review\
Internal Peer Review

#### DESCRIPTION OF METHOD OF GUIDELINE VALIDATION

These guidelines were reviewed by Council and approved by the Board of
Trustees of the American Academy of Ophthalmology (September 16, 2006).

### RECOMMENDATIONS

#### MAJOR RECOMMENDATIONS

Ratings of importance to the care process (A-C) and ratings of strength
of evidence (I-III) are defined at the end of the \"Major
Recommendations\" field.

**Diagnosis**

Preoperative visual acuity is a poor predictor of postoperative
functional improvement; therefore, the decision to recommend cataract
surgery should not be made on the basis of visual acuity alone (Schein
et al., 1994; Schein et al., 1995) \[A:II\].

The patient should be asked specifically about near and distant vision
under varied lighting conditions for activities that the patient views
as important \[A:III\].

**Ophthalmic Evaluation**

The comprehensive evaluation (history and physical examination) includes
those components of the comprehensive adult medical eye evaluation
(Preferred Practice Patterns Committee, 2005) specifically relevant to
the diagnosis and treatment of a cataract as listed below:

-   Patient history \[A:III\], including the patient\'s assessment of
    functional status, pertinent medical conditions, medications
    currently used, and other risk factors that can affect the surgical
    plan or outcome of surgery (e.g., immunosuppressive conditions,
    sympathetic alpha-1a antagonists).

-   Visual acuity with current correction (the power of the present
    correction recorded) at distance and when appropriate at near.
    \[A:III\]

-   Measurement of best-corrected visual acuity (with refraction when
    indicated). \[A:III\]

-   External examination (lids, lashes, lacrimal apparatus, orbit).
    \[A:III\]

-   Examination of ocular alignment and motility. \[A:III\]

-   Assessment of pupillary function. \[A:III\]

-   Measurement of intraocular pressure (IOP). \[A:III\]

-   Slit-lamp biomicroscopy of the anterior segment. \[A:III\]

-   Dilated examination of the lens, macula, peripheral retina, optic
    nerve, and vitreous. \[A:III\]

-   Assessment of relevant aspects of the patient\'s mental and physical
    status. \[B:III\]

**Management**

**Nonsurgical Management**

At the present time, the highest quality evidence does not support a
benefit from nutritional supplementation in preventing or delaying
progression of cataracts; therefore, treatment with supplements is not
recommended. (Huang et al., 2006) \[A:I\]

Patients who are currently smoking should be informed of the increased
risk of cataract progression and the benefits of smoking cessation in
retarding the progression of cataracts that have been demonstrated in
several studies. (West et al., 1989; Christen et al., 1992; Christen et
al., 2000) \[A:II\] Studies have found that smokers report that a
physician\'s advice to quit is an important motivator in attempting to
stop smoking. (National Cancer Institute \[NCI\], 1994; Ockene, 1987;
Pederson, Baskerville & Wanklin, 1982; Ranney et al., 2006). Patients
who are long-term users of oral or inhaled corticosteroids should be
informed of the increased risk of cataract formation (Garbe, Suissa &
Lelorier, 1998; Jick, Vasilakis-Scaramozza & Maier 2001; Klein et al.,
2001; Smeeth et al., 2003; Urban & Cotlier, 1986) \[A:II\] and may wish
to discuss alternate medications with their primary care physician.
Patients with diabetes mellitus should be informed of their increased
risk of cataract formation. (Hennis et al., 2004; Klein, Klein & Lee,
1998; Leske et al., 1999) \[A:II\]. Brimmed hats and ultraviolet-B
blocking sunglasses are reasonable precautions to recommend to patients.
(McCarty, Nanjan & Taylor, 2000).

**Surgical Management**

*Indications for Surgery*

-   The primary indication for surgery is visual function that no longer
    meets the patient\'s needs and for which cataract surgery provides a
    reasonable likelihood of improved vision. \[A:III\]

-   Other indications for a cataract removal include the following:

    -   Clinically significant anisometropia in the presence of a
        cataract. \[A:III\]

    -   The lens opacity interferes with optimal diagnosis or management
        of posterior segment conditions. \[A:III\]

    -   The lens causes inflammation (phacolysis, phacoanaphylaxis).
        \[A:III\]

    -   The lens induces angle closure (phacomorphic or phacotopic).
        \[A:III\]

The ophthalmologist who is to perform the cataract surgery has the
following responsibilities:

-   To examine the patient preoperatively (see \"Ophthalmic Evaluation\"
    above). \[A:III\]

-   To ensure that the evaluation accurately documents the symptoms,
    findings, and indications for treatment. \[A:III\]

-   To obtain informed consent from the patient or the patient\'s
    surrogate decision maker after discussing the risks, benefits, and
    expected outcomes of surgery, including anticipated refractive
    outcome and the surgical experience. \[A:III\]

-   To review the results of presurgical and diagnostic evaluations with
    the patient or the patient\'s surrogate decision maker. \[A:III\]

-   To formulate a surgical plan, including selection of an appropriate
    intraocular lens (IOL). \[A:III\]

-   To formulate postoperative care plans and inform the patient or the
    patient\'s surrogate decision maker of these arrangements (setting
    of care, individuals who will provide care). \[A:III\]

-   To afford the patient or the patient\'s surrogate decision maker the
    opportunity to discuss the costs associated with surgery. \[B:III\]

All patients undergoing cataract surgery should have a history and
physical examination relevant to the risk factors for undergoing the
planned anesthesia and sedation and as directed by a review of systems.
\[A:III\] For patients with certain severe systemic diseases (e.g.,
chronic obstructive pulmonary disease, recent myocardial infarction,
unstable angina, poorly controlled diabetes, or poorly controlled blood
pressure) a preoperative medical evaluation by the patient\'s physician
should be strongly considered. (Lee et al., 1999). \[A:II\] Laboratory
testing as indicated by the findings in the history and physical
examination is appropriate. (Schein, et al., 2000) \[A:I\].

Given the lack of evidence for an optimal anesthesia strategy during
cataract surgery, the type of anesthesia management should be determined
by the patient\'s needs and the preferences of the patient and surgeon.
(Agency for Healthcare Research and Quality \[AHRQ\], 2000) \[A:II\].

Use of a 5% solution of povidone iodine in the conjunctival cul de sac
is recommended to prevent infection. (Speaker & Menikoff, 1991; Wu et
al., 2006) \[A:II\].

Further management recommendations can be found in the main body of the
original guideline document.

*Postoperative Follow-up*

The frequency of postoperative examinations is based on the goal of
optimizing the outcome of surgery and swiftly recognizing and managing
complications. The table below provides guidelines for follow-up based
on consensus in the absence of evidence for optimal follow-up schedules.

**Table. Postoperative Follow-up Schedule \[A:III\]**

  ------------------------------------------------------------------------
  **Patient Characteristics**      **First    **Subsequent Visits**
                                   Visit**    
  -------------------------------- ---------- ----------------------------
  Without high risks or signs or   Within 48  Frequency and timing
  symptoms of possible             hours of   dependent upon refraction,
  complications following          surgery    visual function, and medical
  small-incision cataract surgery             condition of the eye

  High risk; functionally          Within 24  More frequent follow-up
  monocular; glaucoma or glaucoma  hours of   usually necessary
  suspect patients; intraoperative surgery    
  complications                               
  ------------------------------------------------------------------------

Patients should be instructed to contact the ophthalmologist promptly if
they experience symptoms such as a significant reduction in vision,
increasing pain, progressive redness, or periocular swelling, because
these symptoms may indicate the onset of endophthalmitis \[A:III\].

In the absence of complications, the frequency and timing of subsequent
postoperative visits depend largely on the size or configuration of the
incision; the need to cut or remove sutures; and when refraction, visual
function, and the medical condition of the eye are stabilized. More
frequent postoperative visits are generally indicated if unusual
findings, symptoms, or complications occur, and the patient should have
ready access to the ophthalmologist\'s office to ask questions or seek
care \[A:III\].

Components of each postoperative examination should include: \[A:III\]

-   Interval history, including use of postoperative medications, new
    symptoms, and self-assessment of vision

-   Measurement of visual function (e.g., visual acuity, pinhole
    testing)

-   Measurement of intraocular pressure (IOP)

-   Slit-lamp biomicroscopy

-   Counseling/education for the patient or patient\'s caretaker

-   Management plan

A final refractive visit should be made to provide an accurate
prescription for spectacles to allow for the patient\'s optimal visual
function \[A:III\].

**Provider and Setting**

It is the unique role of the ophthalmologist who performs cataract
surgery to confirm the presence of the cataract and to formulate and
carry out a treatment plan \[A:III\]. The surgical facility should
comply with standards governing the particular setting of care (e.g.,
the Accreditation Association for Ambulatory Health Care, Inc., Joint
Commission for Accreditation of Healthcare Organizations, American
Hospital Association) \[A:III\].

**Counseling/Referral**

Patients with functionally limiting postoperative visual impairment
should be referred for vision rehabilitation (American Academy of
Ophthalmology \[AAO\], 2001) and social services \[A:III\].

**Definitions**:

**Ratings of Importance to Care Process**

Level A, defined as most important\
Level B, defined as moderately important\
Level C, defined as relevant, but not critical

**Ratings of Strength of Evidence**

I.  Level I includes evidence obtained from at least one properly
    conducted, well-designed randomized controlled trial. It could
    include meta-analysis of randomized controlled trials.

II. Level II includes evidence obtained from the following:

    -   Well-designed controlled trials without randomization

    -   Well-designed cohort or case-control analytic studies,
        preferably from more than one center

    -   Multiple-time series with or without the intervention

III. Level III includes evidence obtained from one of the following:

     -   Descriptive studies

     -   Case reports

     -   Reports of expert committees/organization (e.g., Preferred
         Practice Pattern panel consensus with peer review)

#### CLINICAL ALGORITHM(S)

None provided

### EVIDENCE SUPPORTING THE RECOMMENDATIONS

#### REFERENCES SUPPORTING THE RECOMMENDATIONS

[References open in a new
window](http://www.guideline.gov/summary/select_ref.aspx?doc_id=10173)

#### TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

The type of supporting evidence is identified and graded for each
recommendation (see \"Major Recommendations.\")

### BENEFITS/HARMS OF IMPLEMENTING THE GUIDELINE RECOMMENDATIONS

#### POTENTIAL BENEFITS

-   Improved visual function as a result of cataract surgery

-   Improved physical function as a critical outcome of cataract surgery

-   Improved mental health and emotional well-being as a second critical
    outcome of cataract surgery

**Subgroups Most Likely to Benefit**

Patients without preoperative ocular comorbidities are more likely to
have better outcomes from cataract surgery than patients with ocular
comorbidities.

#### POTENTIAL HARMS

-   **Cataract Surgery**: Major complications that are potentially
    sight-threatening include infectious endophthalmitis, intraoperative
    suprachoroidal hemorrhage, cystoid macular edema (CME), retinal
    detachment, corneal edema, and intraocular lens dislocation

-   **Intraocular Lenses (IOL)**: The most common reasons for IOL
    explantation include incorrect power, opacification, decentration or
    dislocation, and glare or optical aberrations. A rare late
    complication of IOL implantation is uveitis-glaucoma-hyphema
    syndrome.

-   **Anesthesia**: Anesthesia techniques with needle injection may be
    associated with complications such as strabismus, globe perforation,
    retrobulbar hemorrhage, and macular infarction not seen with
    topical, blunt cannula, and other non-needle injection techniques.

-   **Nd:YAG (Neodymium: Yttrium-Aluminum-Garnet) laser**: Complications
    of Nd:YAG laser capsulotomy include transient and long-term
    increased intraocular pressure (IOP), retinal detachment, CME,
    damage to the intraocular lens (IOL), hyphema, dislocation of the
    IOL, and corneal edema and corneal abrasions from using a focusing
    contact lens for the laser surgery. Axial myopia increases the risk
    of retinal detachment after Nd:YAG laser capsulotomy, as does
    pre-existing vitreoretinal disease, male gender, young age, vitreous
    prolapse into the anterior chamber, and spontaneous extension of the
    capsulotomy.

-   **Ocular Comorbidities**: High-risk characteristics include a
    history of previous eye surgery, special types of cataracts, very
    large and very small eyes, deeply set eyes, eyes with small pupils
    or posterior synechiae, eyes with scarred or cloudy corneas, eyes
    with weak or absent zonules, prior ocular trauma, and the systemic
    use of alpha-1a antagonists.

### CONTRAINDICATIONS

#### CONTRAINDICATIONS

-   Surgery for a visually impairing cataract should **not** be
    performed under the following circumstances:

    -   Eyeglasses or visual aids provide vision that meets the
        patient\'s needs.

    -   Surgery will not improve visual function.

    -   The patient cannot safely undergo surgery because of coexisting
        medical or ocular conditions.

    -   Appropriate postoperative care cannot be arranged.

### QUALIFYING STATEMENTS

#### QUALIFYING STATEMENTS

-   **Preferred Practice Patterns provide guidance for the pattern of
    practice, not for the care of a particular individual**. While they
    should generally meet the needs of most patients, they cannot
    possibly best meet the needs of all patients. Adherence to these
    Preferred Practice Patterns will not ensure a successful outcome in
    every situation. These practice patterns should not be deemed
    inclusive of all proper methods of care or exclusive of other
    methods of care reasonably directed at obtaining the best results.
    It may be necessary to approach different patients\' needs in
    different ways. The physician must make the ultimate judgment about
    the propriety of the care of a particular patient in light of all of
    the circumstances presented by that patient. The American Academy of
    Ophthalmology is available to assist members in resolving ethical
    dilemmas that arise in the course of ophthalmic practice.

-   **Preferred Practice Patterns are not medical standards to be
    adhered to in all individual situations**. The Academy specifically
    disclaims any and all liability for injury or other damages of any
    kind, from negligence or otherwise, for any and all claims that may
    arise out of the use of any recommendations or other information
    contained herein.

-   References to certain drugs, instruments, and other products are
    made for illustrative purposes only and are not intended to
    constitute an endorsement of such. Such material may include
    information on applications that are not considered community
    standard, that reflect indications not included in approved Food and
    Drug Administration (FDA) labeling, or that are approved for use
    only in restricted research settings. The FDA has stated that it is
    the responsibility of the physician to determine the FDA status of
    each drug or device he or she wishes to use, and to use them with
    appropriate patient consent in compliance with applicable law.

### IMPLEMENTATION OF THE GUIDELINE

#### DESCRIPTION OF IMPLEMENTATION STRATEGY

> An implementation strategy was not provided.

#### IMPLEMENTATION TOOLS

> Personal Digital Assistant (PDA) Downloads\
> Quick Reference Guides/Physician Guides
>
> For information about
> [availability](#identifying-information-and-availability), see the
> \"Availability of Companion Documents\" and \"Patient Resources\"
> fields below.

### INSTITUTE OF MEDICINE (IOM) NATIONAL HEALTHCARE QUALITY REPORT CATEGORIES

#### IOM CARE NEED

> Getting Better

#### IOM DOMAIN

> Effectiveness\
> Patient-centeredness\
> Safety

### IDENTIFYING INFORMATION AND AVAILABILITY

#### BIBLIOGRAPHIC SOURCE(S)

> Cataract in the adult eye. Preferred practice pattern. In: American
> Academy of Ophthalmology (AAO). San Francisco (CA): American Academy
> of Ophthalmology (AAO); 2006. p. 69. \[585 references\]

#### ADAPTATION

> Not applicable: The guideline was not adapted from another source.

#### DATE RELEASED

> 1996 Sep (revised 2006 Sep)

#### GUIDELINE DEVELOPER(S)

> American Academy of Ophthalmology - Medical Specialty Society

#### SOURCE(S) OF FUNDING

> American Academy of Ophthalmology

#### GUIDELINE COMMITTEE

> Cataract and Anterior Segment Panel; Preferred Practice Patterns
> Committee

#### COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

> *Cataract and Anterior Segment Panel Members*: Samuel Masket, MD
> (*Chair*) American Society for Cataract and Refractive Surgery
> Representative; David F. Chang, MD; Stephen S. Lane, MD; Richard H.
> Lee, MD; Kevin M. Miller, MD; Roger F. Steinert, MD; Rohit Varma, MD,
> MPH, Methodologist
>
> *Preferred Practice Patterns Committee Members*: Sid Mandelbaum, MD
> (*Chai*r); Linda M. Christmann, MD, MBA; Emily Y. Chew, MD; Douglas E.
> Gaasterland, MD; Samuel Masket, MD; Christopher J. Rapuano, MD;
> Stephen D. McLeod, MD; Donald S. Fong, MD, MPH, Methodologist
>
> *Academy Staff*: Nancy Collins, RN, MPH; Doris Mizuiri; Flora C. Lum,
> MD

#### FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

> These authors have disclosed the following financial relationships
> occurring from January 2005 to August 2006:
>
> Samuel Masket, MD: Advanced Medical Optics, Medennium, IntraLase --
> Affiliation. Alcon -- Affiliation. Consultant/Advisor. Lecture fees.
> Othera Pharmaceuticals -- Compensation. Consultant/Advisor. Power
> Vision -- Consultant/Advisor. Visiogen -- Affiliation.
> Consultant/Advisor.
>
> David F. Chang, MD: Advanced Medical Optics -- Affiliation.
> Compensation. Consultant/Advisor. Alcon -- Compensation.
> Consultant/Advisor. Calhoun Vision -- Equity owner. Cataract &
> Refractive Surgery Today -- Affiliation. Ista Pharmaceuticals --
> Lecture fees. Slack -- Consultant/Advisor. Patents/Royalty. Visiogen
> -- Affiliation. Consultant/Advisor.
>
> Stephen S. Lane, MD: Alcon -- Affiliation. Ownership. Compensation.
> Consultant/Advisor. Lecture fees. Bausch and Lomb -- Affiliation.
> Compensation. Consultant/Advisor. Lecture fees. Medennium, Surgical
> Specialties -- Affiliation. Visiogen -- Affiliation. Ownership.
> Compensation. Consultant/Advisor. VisionCare Ophthalmic Technologies
> -- Affiliation. Compensation. Consultant/Advisor. WaveTech --
> Consultant/Advisor.
>
> Kevin M. Miller, MD: Alcon -- Compensation. Lecture/Advisor. Grant
> support. Hoya -- Compensation. Grant support. STAAR Surgical -- Equity
> owner.
>
> Roger F. Steinert, MD: Advanced Medical Optics -- Affiliation.
> Compensation. Consultant/Advisor. Alcon -- Affiliation. Compensation.
> Allergan -- Lecture fees. IntraLase -- Affiliation. Compensation.
> Consult/Advisor. Grant support. ReVision Optics -- Consultant/Advisor.
> Rhein Medical -- Compensation. Carl Zeiss Meditec --
> Consultant/Advisor. Lecture fees.
>
> Rohit Varma, MD, MPH: Alcon -- Consultant/Advisor. Allergan -- Lecture
> fees. National Eye Institute -- Grant support. Pfizer Ophthalmics --
> Compensation. Lecture fees.

#### GUIDELINE STATUS

> This is the current release of the guideline.
>
> This guideline updates a previous version: American Academy of
> Ophthalmology (AAO), Anterior Segment Panel. Cataract in the adult
> eye. San Francisco (CA): American Academy of Ophthalmology (AAO);
> 2001. 62 p.
>
> All Preferred Practice Patterns are reviewed by their parent panel
> annually or earlier if developments warrant and updated accordingly.
> To ensure that all Preferred Practice Patterns are current, each is
> valid for 5 years from the \"approved by\" date unless superseded by a
> revision.

#### GUIDELINE AVAILABILITY

> Electronic copies: Available from the [American Academy of
> Ophthalmology (AAO) Web
> site](http://www.aao.org/education/guidelines/ppp/index.cfm).
>
> Print copies: Available from American Academy of Ophthalmology, P.O.
> Box 7424, San Francisco, CA 94120-7424; telephone, (415) 561-8540.

#### AVAILABILITY OF COMPANION DOCUMENTS

> The following are available:

-   Summary benchmarks for preferred practice patterns. San Francisco
    (CA): American Academy of Ophthalmology; 2006 Nov. 21 p.

> Available in Portable Document Format (PDF) from the [American Academy
> of Ophthalmology (AAO) Web
> site](http://www.aao.org/education/guidelines/benchmarks/index.cfm).
>
> Print copies: Available from American Academy of Ophthalmology, P.O.
> Box 7424, San Francisco, CA 94120-7424; telephone, (415) 561-8540.

#### PATIENT RESOURCES

> None available

#### NGC STATUS

> This NGC summary was completed by ECRI on February 20, 1999. The
> information was verified by the guideline developer on April 23, 1999.
> This summary was updated on January 8, 2002. The updated information
> was verified by the guideline developer as of February 19, 2002. This
> NGC summary was updated on January 4, 2007. The updated information
> was verified by the guideline developer on January 30, 2007.

#### COPYRIGHT STATEMENT

> This NGC summary is based on the original guideline, which is subject
> to the guideline developer\'s copyright restrictions. Information
> about the content, ordering, and copyright permissions can be obtained
> by calling the American Academy of Ophthalmology at (415) 561-8500.

### DISCLAIMER

#### NGC DISCLAIMER

> The National Guideline Clearinghouse™ (NGC) does not develop, produce,
> approve, or endorse the guidelines represented on this site.
>
> All guidelines summarized by NGC and hosted on our site are produced
> under the auspices of medical specialty societies, relevant
> professional associations, public or private organizations, other
> government agencies, health care organizations or plans, and similar
> entities.
>
> Guidelines represented on the NGC Web site are submitted by guideline
> developers, and are screened solely to determine that they meet the
> NGC Inclusion Criteria which may be found at
> <http://www.guideline.gov/about/inclusion.aspx> .
>
> NGC, AHRQ, and its contractor ECRI Institute make no warranties
> concerning the content or clinical efficacy or effectiveness of the
> clinical practice guidelines and related materials represented on this
> site. Moreover, the views and opinions of developers or authors of
> guidelines represented on this site do not necessarily state or
> reflect those of NGC, AHRQ, or its contractor ECRI Institute, and
> inclusion or hosting of guidelines in NGC may not be used for
> advertising or commercial endorsement purposes.
>
> Readers with questions regarding guideline content are directed to
> contact the guideline developer.

Bottom of Form

> © 1998-2008 National Guideline Clearinghouse
>
> Date Modified: 11/3/2008
>
>  
>
>