Waiting Times for Cataract Surgery in a Dedicated Cataract Clinic: A Retrospective Audit
Abstract
A retrospective clinical audit assessing changes in access to cataract surgery within a Dedicated Cataract Clinic over two consecutive audit periods.
Cataract surgery is an effective and cost-effective intervention that helps prevent avoidable visual impairment and maintain functional independence. Timely access is therefore an important indicator of surgical-system performance and healthcare equity. Despite Dedicated Cataract Clinics being introduced to improve efficiency and throughput, elective ophthalmology services continue to experience capacity constraints.
To assess waiting times for cataract surgery in a Dedicated Cataract Clinic and analyse changes in access over two years.
A retrospective clinical audit examined cataract surgery waiting-list data for patients undergoing surgery during March–April 2024 and March–April 2025. Waiting times for all eyes, first-eye surgery and second-eye surgery were examined using descriptive statistics and non-parametric comparisons.
A total of 233 cataract surgeries were examined: 114 in 2024 and 119 in 2025. Median waiting time for all eyes increased from 113.5 days in 2024 to 194.0 days in 2025 (p = 0.0002). First-eye waiting time increased from 109.0 to 171.0 days (p = 0.0175), while second-eye waiting time increased from 134.5 to 322.0 days (p = 0.0008).
Waiting times for cataract surgery increased significantly over the 12-month period, indicating increasing service pressure and insufficient capacity to meet demand despite the dedicated service model. Continuous audit, capacity optimisation and targeted system-level interventions are required to support timely and equitable access.
Cataract surgeries included across both audit periods.
Cataract procedures during March–April 2024.
Cataract procedures during March–April 2025.
Retrospective clinical audit of routinely collected service data.
113.5 → 194 days
Median waiting time for all cataract procedures increased from 113.5 days in 2024 to 194.0 days in 2025 (p = 0.0002).
109 → 171 days
Median first-eye waiting time increased from 109.0 days in 2024 to 171.0 days in 2025 (p = 0.0175).
134.5 → 322 days
Second-eye procedures experienced the greatest increase, with median waiting time rising from 134.5 days to 322.0 days (p = 0.0008).
114 → 119
Overall surgical activity remained relatively stable, suggesting that increasing waiting times occurred despite similar procedural throughput across the two audit periods.
90 → 91
First-eye procedures remained almost unchanged: 90 surgeries in 2024 compared with 91 in 2025.
24 → 28
Second-eye surgical activity increased modestly from 24 procedures in 2024 to 28 procedures in 2025, despite the substantial increase in waiting time.
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Retrospective Clinical Audit
The study was conducted as a retrospective clinical audit to assess service performance and support quality improvement, rather than to test hypotheses or generate generalisable research findings.
Dedicated Cataract Clinic
The audit was undertaken within a Dedicated Cataract Clinic at a publicly financed regional hospital. The hospital was anonymised in the published article in accordance with the audit and service-evaluation approach.
2024 vs 2025
Surgical waiting-list data were examined for patients undergoing cataract surgery during March–April 2024 and March–April 2025.
First- & Second-Eye Procedures
Both first-eye and second-eye cataract procedures were included to examine differences in prioritisation and access between the two surgical categories.
Waiting Time
Waiting time was defined as the number of days between placement on the surgical waiting list and the date on which cataract surgery was performed.
GraphPad Prism Version 10
Descriptive statistics and normality testing were performed. Non-parametric statistical methods were used because the waiting-time distributions were skewed. Median differences and Hodges–Lehmann estimators were calculated, with statistical significance set at p < 0.05.
Clinical Audit / Quality Improvement
Ethical approval was not requested because the work was conducted as a clinical audit of routinely collected service data for quality improvement. No patient-identifiable information was used, and usual clinical care was not altered.
Waiting-Time Pressure
The published audit reported 2025 median waiting times of 171 days for first-eye surgery, 322 days for second-eye surgery and 194 days across all cataract procedures.
Four-Domain Approach
The article proposes four areas for cataract-access improvement: capacity optimisation, improved pathway efficiency, transparent and equitable prioritisation, and continuous performance monitoring through audit cycles and waiting-time dashboards.
Capacity and Equitable Access
The findings support proactive capacity planning, workforce optimisation, protected theatre capacity, transparent prioritisation and routine monitoring of waiting times, with particular attention to preserving access to second-eye cataract surgery.
Single-Service Audit
The audit was limited to one service and two defined time periods. Patient-reported outcomes, referral patterns and workforce indicators were not examined.
CRediT Statement
Original draft & formal analysis:
Emma Hennessy and Emily Greenan.
Review, editing & data curation:
Adebusola Adenike Owokole.
Supervision:
Conall Hurley.
Conflict of Interest & Funding
Conflict of Interest:
No conflict of interest.
Funding:
No funding received by the authors.
Editorial Timeline
CC BY 4.0
Published by The Operating Room Global Journal under the
Creative Commons Attribution 4.0 International licence.
DOI: 10.64573/torgj2512005
Volume 1 · Issue 2 · 2025
The Operating Room Global Journal (TORGJ). ISSN 3105-3262. Article DOI: 10.64573/torgj2512005.
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