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Cataract surgery rates have soared 10-fold over the past 40 years in England because of changes in referrals from channels such as optical practices and a government push to boost supply, according to research findings due to be published in the British Journal of Ophthalmology.

But the huge increase and wide geographical variation in rates suggest that the NHS is now oversupplied with the procedure, which has led to funding shortages and training issues, the authors claim.

The research team analysed national data on hospital admissions for cataract surgery in England from 1968 to 2004. They also looked at similar data for the former regional health authority area of Oxford.

The analysis of the national data showed that cataract surgery rates rose 10-fold between the assessed periods.

Both national and regional data showed a five-fold increase from the late 1980s to 2003.

For example, research findings revealed that admission rates in England rose from 62 per 100,000 of the population in 1968, to 173 in 1989, and then to 637 in 2004.

This suggests either real differences in the prevalence of cataract, or differences in referral patterns, the authors said. They also questioned whether some areas are 'overservicing'.

'The fact that cataract surgery has increased so much in recent years raises questions as to whether it is now undertaken too readily in some cases, and whether the long backlogs of clinical need are still being cleared,' researchers write.

They suggest that England should learn from New Zealand, where patients are prioritised according to clinical need rather than the availability of surgeons or waiting time targets. 'The possibility of overcapacity in England would have profound financial implications for the commissioning of surgery by primary care trusts, and for professional training,' they conclude.

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