E-Mail karger@karger.com Mini Review Ophthalmic Res 2017;58:67–73 DOI: 10.1159/000456721 French Medical-Administrative Database for Epidemiology and Safety in Ophthalmology (EPISAFE): The EPISAFE Collaboration Program in Cataract Surgery Vincent Daien a–c Jean-Francois Korobelnik e–g Cécile Delcourt f, g Audrey Cougnard-Gregoire f, g Marie Noelle Delyfer e–g Alain M. Bron h, i Isabelle Carrière b, c Max Villain a, b Jean Pierre Daures d Sandy Lacombe d Anne Sophie Mariet i–n Catherine Quantin i–n Catherine Creuzot-Garcher h, i a Department of Ophthalmology, Montpellier University Hospital, b University of Montpellier, c Inserm U1061, and d Department of Biostatistics, Epidemiology and Clinical Research EA2415, University of Montpellier, Montpellier, e Service d’Ophtalmologie, CHU de Bordeaux, f ISPED, Université de Bordeaux, and g Inserm U1219, Bordeaux Population Health Research Center, Bordeaux, and h Department of Ophthalmology, University Hospital Dijon, i Eye and Nutrition Research Group, CSGA, UMR 1324 INRA, j Biostatistics and Bioinformatics (DIM), k Bourgogne Franche-Comté University, l Inserm CIC 1432, m Clinical Epidemiology/Clinical Trials Unit, Clinical Investigation Center, Dijon University Hospital, and n Inserm UMR 1181, Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), Bourgogne Franche-Comté University, Dijon, France French private or public healthcare facilities, and date of death. The use of this database provides information at the scale of the entire country, allowing measurement of the im- pact of changes in practices and new guidelines. Between 2009 and 2012, a total of 2,717,203 eyes in 1,817,865 patients underwent cataract surgery in France, and the incidence of cataract surgery increased from 9.86 to 11.08/1,000 person- years. The 4-year cumulative risk of retinal detachment was 0.99%, and patients <60 years of age were at higher risk of retinal detachment. The incidence of pseudophakic cystoid macular edema was 0.95%. From 2005 to 2014, from data including more than 6 million procedures, the incidence of endophthalmitis after cataract surgery decreased from 0.15 to 0.05%. The EPISAFE collaboration program encompasses the key issues facing ophthalmology, including public health and public policy concerning disease incidence and preva- lence, safety and adverse event monitoring, and clinical guidelines. © 2017 S. Karger AG, Basel Keywords Big data · Pharmacoepidemiology · Safety · Ophthalmology · Cataract Abstract Medical-administrative databases are an important source of big data to assess the epidemiology of diseases and inter- ventions, compare drugs, and investigate rare adverse events. We describe the French national health insurance system databases and the Epidemiology and Safety (EPI- SAFE) collaboration program in ophthalmology and illus- trate the paper with recent studies that used the databases to investigate cataract surgery. The Système national d’in- formation inter-régime de l’assurance maladie (SNIIR-AM) is one of the largest databases of medical and administrative data for a general population, covering nearly 65 million people. The SNIIR-AM database links data for all outpatient- reimbursed health expenditures, hospitalization in all 1,546 Received: January, 10, 2017 Accepted: January 18, 2017 Published online: April 4, 2017 Vincent Daien Service d’Ophtalmologie, Hôpital Gui de Chauliac, CHU de Montpellier 80, Avenue Augustin Fliche FR–34295 Montpellier Cedex 5 (France) E-Mail v-daien  @  chu-montpellier.fr © 2017 S. Karger AG, Basel www.karger.com/ore