Ophthalmologist-guided screening and monitoring in local anesthesia for intraocular lens surgery

Session Details

Session Title: Endophthalmitis/ Ocular Infections/ Miscellaneous

Session Date/Time: Tuesday 10/10/2017 | 08:00-10:30

Paper Time: 10:04

Venue: Room 4.6

First Author: : R.Lapid-Gortzak THE NETHERLANDS

Co Author(s): :    Y. Wu   I. van der Meulen   C. Nieuwendaal   M. Mourits   J. van der Linden        

Abstract Details

Purpose:

To evaluate safety of patients who had ophthalmologist-guided preoperative screening and intraoperative monitoring of intraocular lens surgery under local anesthesia.

Setting:

Retina Total Eye Care, Driebergen, the Netherlands.

Methods:

A retrospective cohort study of patients who had intraocular lens surgery between October, 2007 to October, 2016 were included. Preoperative screening, American Society of Anesthesiologists (ASA) classification, and intraoperative monitoring were performed by ophthalmologists. The main outcome measures included incidence of intra- and postoperative life-threatening complications, need for reanimation, hospitalization within 24 hours and one week after surgery, and non-fatal adverse events occurred.

Results:

In 2003 patients, no intraoperative or postoperative life-threatening complication was noted. Only patients with ASA I and II classification were operated. No assistance of a reanimation team was needed. Intraoperative adverse events occurred in 0.9%, most commonly tachycardia. Diabetic mellitus and hyperlipidemia were significantly related to intraoperative adverse events (p=0.016 and 0.005). The hospitalization rate was 0% within 24 hours and 0.05% within one week after the operation.

Conclusions:

Ophthalmologist-guided screening and monitoring are safe and efficient for patients with ASA I and II classification with intraocular lens surgery under local anesthesia and oral sedation. There is no need for screening by an anesthesiologist or a nurse anesthetist. Tachycardia is the most common intraoperative adverse event that warrants surgeon’s attention, especially in middle-aged patients with comorbidity.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a competing company, travel has been funded, fully or partially, by a competing company, research is funded, fully or partially, by a competing company