Husein Al-Kazwini
Introduction
Cataract surgery is the most commonly performed operation worldwide, with more than 9.5 million procedures undertaken annually. In the UK, a cancelled cataract operation costs the National Health Service approximately £911 per patient, highlighting the financial impact of late cancellations. Optimising theatre utilisation is therefore an important target for quality improvement. This audit aimed to quantify cancelled phacoemulsification procedures and identify modifiable factors contributing to cancellations.
Methods
Data was collected for all day-of-surgery cancellations at King’s College Hospital South Sites involving phacoemulsification cataract surgery (including combined surgeries) between January 2025 and January 2026. Cancellations were categorised into five primary groups based on underlying cause: medically unfit
patient, ocular condition unsuitable for surgery, patient-related, administrative or logistical factors, and surgeon-related factors. Categories were further subdivided to identify specific causes.
Results
Between January 2025 and January 2026, 387 phacoemulsification procedures were cancelled on-the-day. Administrative factors accounted for 111 cancellations (28.7%). Patients who were medically unfit or had an ocular condition unsuitable for surgery accounted for 112 cancellations (28.9%); with over half of these (62/112) reflecting factors such as raised blood pressure, blood glucose, or anticoagulation identified on the day. Patient-related factors such as non-attendance or acute illness accounted for 77 cancellations (19.9%), while surgeon-related factors accounted for 64 (16.5%).
Conclusions
Administrative factors were a major contributor to cancellations. Additionally, over half of patients deemed medically-unfit had potentially optimisable factors identifiable during pre-operative assessment. Addressing these areas represents an important opportunity to reduce avoidable cancellations and improve efficiency in high-volume cataract services.
Authors
Hussein Al-Kazwini, Sara Memon
King's College Hospital NHS Foundation Trust, London, United Kingdom