Author’s Disclosure Block: Joshua Bierbrier, none; Stephanie Baxter, none; Davin Johnson, none

Abstract Body
Purpose:The Ontario government funds out-of-hospital independent health facilities (IHFs) to perform elective cataract surgeries. It is paramount to ensure that cataract surgeries are safe regardless of the clinical setting in which they are performed. Therefore, we investigated the complication rates of cataract surgery at a hospital and an IHF. Intra- (posterior capsular rupture, PCR) and post-operative (endophthalmitis and retinal tear/detachment) complications were considered. Study Design: We performed a retrospective chart review of elective cataract surgeries at an Ontario hospital and IHF. Methods: Electronic medical records between January 1 – December 31, 2023, were assessed. Age, lens type, eye, and complications were collected. Intra-operative complications were identified in operative reports. Post-operative complications were identified by assessing appointments within 30 days of surgery. Surgeries with additional procedures (glaucoma/corneal procedures) and those performed by retina specialists were excluded. Statistical tests were performed in Python with a significance level of p<0.05. Fisher’s Exact tests with Bonferroni corrections were used to assess operative complications. Lens use was assessed with Chi-square a test. Results: A total of 3190 (Hospital: 1741, IHF: 1449) charts were reviewed. The average age across sites was 72.4 (Hospital: 72.1, IHF: 72.8) and eye laterality was equal.There was a significant difference in the rate of PCRs between the hospital (n=25, 1.44%) and IHF (n=3, 0.21%). Logistic regression modelling did not identify age or eye as significantly affecting the complication rate. Two cases of endophthalmitis were identified at the IHF (0.14%) and zero at the hospital. Five retinal tears/detachments occurred at the hospital (0.29%) and zero at the IHF. There was no significant difference between the rates of endophthalmitis or retinal tear/detachment between the sites. The rate of premium lens use was significantly higher at the IHF compared to the hospital. Conclusions: The findings suggest that surgery in both clinical settings is safe. Complications rates at both sites are within reported ranges. The results can be used for quality improvement and to advocate for increased per-case hospital funding of complex cases.