Clinical Practice Guidelines for the Management of Adult Cataract; Customized for Iranian Population

To customize clinical practice guidelines (CPGs) for cataract management for Iranian population. First, four CPGs (American Academy 2006 and 2011, Royal College of Ophthalmologists 2010 and Canadian Ophthalmological Society evidence-based clinical practice guidelines 2008) were selected from a number of available CPGs for cataract management in the literature. Second, all recommendations of these guidelines together with their supporting sources were studied. Each recommendation was summarized in 4 tables; the first table entailed the recommendation itself in clinical question components format along with its level of evidence. The second table contained the abstracts of the supporting articles in clinical question components format together with their levels of evidence. The third table covered the customized recommendation of the group respecting Iran’s condition, its clinical advantage, cost and complications. In the fourth table, the customizing team scored the recommendation from 1 to 9 based on the customizing capability of the recommendation (applicability, acceptability, external validity). At last, customized recommendations were sent to the faculty members of all universities across the country one month prior to the consensus session asking their comments. The agreed-upon items were accepted as the conclusive recommendations while the ones that they had no agreements on were discussed at the consensus session. Finally, all customized recommendations were codified as 81 recommendations along with their sources and levels of evidence for Iranian population. It seems that customizing the CPGs of adult cataract management could be effectively useful in standardization of referral, diagnosis and treatment of the affected subjects.