Ten-year trends of immediate sequential bilateral cataract surgery (ISBCS) as reflected in the Swedish National Cataract Register.

PURPOSE: To analyse trends of ISBCS reported to the Swedish National Cataract Register (NCR) over a 10-year period. METHODS: Since 2010 the NCR contains social security number of all individuals in the list of parameters reported to NCR after each cataract procedure. Bilateral surgeries were mapped out using social security numbers. When dates of both-eye surgeries are identical for an individual it is classified as an immediate sequential bilateral cataract surgery (ISBCS). This study includes all data reported during the period 1st of January 2010 to 31st of December 2019. During the study period 113 cataract surgery clinics affiliated to the NCR reported their data on consecutive cataract cases. RESULTS: For the whole period 54 194 ISBCS were reported. The total number of bilateral cataract extractions was 422 300. There was a significant trend of increasing ISBCS over time with linear regression (Beta = 1.75, p < 0.001). In ISBCS the occurrence of an ocular comorbidity decreased over time. The use of a capsular tension ring was significantly more common in ISBCS than in delayed sequential bilateral cataract surgery (DSBCS). All other measures taken during surgery were more common in DSBCS. The use of multifocal IOL was significantly more frequent in ISBCS compared to DSBCS (p < 0.001). CONCLUSIONS: The use of ISBCS has increased over the study period. The operated eyes have less risk factors than eyes going through a DSBCS, but both ocular comorbidities and surgical complications occur in ISBCS eyes.

[Doctors without patients - the background of the Swedish bottom placement in OECD comparison of consultations per doctor]. / Sveriges bottenplacering i OECD:s rankning används fel - Antal patientbesök per läkare i Sverige underskattas ­ mätetalet säger mer om skillnader än brister.

Sweden ranks low in an international comparison of consultations per doctor. This has several structural reasons. Compared to other countries Sweden reports nearly all physicians, including residents and interns and physicians on parental or sick leave. Information on the number of consultations is gathered from each county's administrative data. No national health insurance registry exists. Telephone consultations are not included. Comparisons of consultations per doctor have several sources of error and do not take length and quality of the consultation into account. In its present form, it should not be used to measure the productivity of the health care system.

[An eye for an eye? Lack of consensus in off-label use of medications leads to major regional differences in medical costs for the treatment of wet AMD in Sweden]. / Öga för öga? - Olika syn på förskrivning ¼off label« ger stora regionala skillnader i behandling vid sjukdom i gula fläcken.

An eye for an eye? Lack of consensus in off-label use of medications leads to major regional differences in medical costs for the treatment of wet AMD in Sweden. The three ocular VEGF inhibitors available in Sweden have similar efficacy and safety. Only two are however registered for wet AMD. The remaining, Avastin, is developed for oncological indications, but used for wet AMD in many parts of the world. Major regional differences exist in the use of Avastin in Sweden. In the three largest cities, it is not used at all. As a consequence, the yearly drug cost for a patient with wet AMD differs from 2 000 to 44 000 SEK. As this difference is not compatible with the Swedish law of "care on equal terms", increased efforts should be made to obtain a national consensus.