Session: Poster session C

The incidence of incorrect eye muscle operations in the Netherlands

Abstract:

Title: The incidence of incorrect eye muscle operations in the Netherlands

 

Introduction: Even with the help of a time out procedure, the risk of making a mistake with the scheduled operation in strabismus surgery is probably higher than in other ophthalmic operations due to the possibility of not only operating on the wrong eye, but also the possibility of operating on the wrong muscle or doing the wrong procedure on that muscle.

Methods: We sent a survey to all ophthalmologists who perform strabismus operations in the Netherlands. The survey included questions about the amount of strabismus surgery they perform yearly, how many years they perform strabismus surgery and whether the surgeon had ever performed incorrect eye muscle surgery, if so, we asked them if they operated on the wrong eye or wrong muscle and how many times they performed incorrect eye surgery. we also asked them what procedure they use to avoid wrong eye surgery  and whether they have changed their procedure to prevent mistakes since.

Results: we were able to identify 86 strabismus surgeons in the Netherlands, of which 66 completed the survey, 20 had performed an incorrect eye muscle operation, most cases involved an incorrect muscle.

Conclusion:  Incorrect eye muscle operations for strabismus occur in about 1 in 3 surgeons in the Netherlands, most surgeons adapted their procedure to avoid another wrong eye surgery.