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Cataract surgery under general anaesthesia: indications and outcomes

Poster Details

First Author: W.Muen UK

Co Author(s):    S. Koay   H. Sherafat   W. Muen              

Abstract Details

Purpose:

To study indications, outcomes and complications of cataract surgery under general anaesthesia (GA).

Setting:

Royal Eye Unit (REU), Kingston Hospital, Kingston Upon Thames, United Kingdom

Methods:

Retrospective review of all cataract surgery performed under GA from 01/01/2016 to 20/01/2017. Surgeries were performed by Consultants in the REU, Kingston Hospital. Our primary outcome measure was improvement in best corrected visual acuity (BCVA). Secondary outcome measures were: indications for GA, complications of GA, and intraoperative and postoperative surgical complications. Dissolvable sutures were commonly used to protect the anterior chamber in case of eye rubbing. The REU carries out over 1900 cataract cases per year and is a recognised centre for complex cases.

Results:

23 eyes of 21 patients (1.16% of all cataract surgery) were included. Mean age was 71.9 years (�13.8), with a 1:1.3 female: male ratio. Indications for GA included extreme anxiety (39%), dementia (26%), learning difficulty (21%), and severe positional problems (13%). No significant complications from GA were seen in our patient group. BCVA testing was only possible in 19 eyes, with a mean improvement of logMAR 0.4 (�0.9). Whilst BCVA measurements were impossible in 3 dementia patients, subjective improvement was reported. There were no post-operative complications, including endophthalmitis.

Conclusions:

Although the vast majority of cataract surgery is performed under local anaesthetic (usually topical), there is still a role for GA in selected patients. Our results show that cataract surgery can be successfully performed with no anaesthetic or surgical complications. Good final visual outcomes were achieved and were of benefit to these patients. In these groups of patients intra-venous sedation was not deemed to be suitable and may have led to a higher level of operative complications.

Financial Disclosure:

NONE

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