Cataract Surgery Risk Score - Medical Algorithm

Najjar and Awwad proposed a risk score for cataract surgery. The authors are from Philadelphia and Dallas.

Parameters:

(1) age of the patient

(2) type of anesthesia

(3) cataract density

(4) frontal bossing or sunken globes

(5) high hyperopia or myopia (far or near sightedness)

(6) ophthalmic history in eye being operated on

(7) history of complications in other eye

(8) anterior chamber

(9) cloudiness of cornea

(10) red reflex

(11) pseudoexfoliation

(12) papillary dilatation

Parameter	Finding	Points
age of the patient	< 50 years	1
	50 to 65 years	2
	66 to 80 years	3
	> 80 years	4
type of anesthesia	general	0
	local	2
	topical	3
frontal bossing or sunken globe	absent	0
	present	1
high hyperopia or myopia	absent	0
	present	1
history of glaucoma, uveitis or previous intraocular surgery	absent	0
	present	1
history of complications in other eye	absent	0
	present	1
shallow anterior chamber	absent	0
	present	1
cornea	not cloudy	0
	cloudy	1
red reflex	good to fair	0
	poor	1
pseudoexfoliation	absent	0
	present	3
pupillary dilatation	good to fair	0
	poor	3

Nuclear Sclerosis	Anterior and/or Posterior Subcapsular Opacities	Points
mild	mild to moderate	2
mild	dense	3
moderate	mild to moderate	1
moderate	dense	2
dense	NA	4

total score =

= SUM(points for all 12 parameters)

Interpretation:

• minimum score: 2

• maximum score: 25

• The higher the score the greater the surgical risk.

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Cataract Surgery Risk Score of Najjar and Awwad