Bilateral simultaneous cataract surgery in a public hospital

Poster Details

First Author: A.Morgante ITALY

Co Author(s):    F. Scandellari   S. Borin   M. Cargnoni   R. Bellucci     

Abstract Details

Purpose:

Over the last 10 years, the improved safety and efficacy of cataract surgery, together with the use of topical anaesthesia and MICS, increased the number of procedures performed yearly in our department from 1200 to 5000. This increased the administrative work on the hospital side, and led to a long waiting list on patient side, inducing dissatisfaction in clerks, nurses, patients, relatives. Given the good results of bilateral simultaneous surgeries published in the literature, and performed by us in uncooperative patients under general anaesthesia, we decided to offer simultaneous surgery to normal cataract cases operated on under topical anaesthesia.

Setting:

Ophthalmic unit hospital and university of verona - italy

Methods:

The correct information and explanation of the benefits of this approach are key factors for good doctor-patient relationships. We propose this surgery to patients with uncomplicated bilateral cataracts. Primarily interested patients are the older, those with reduced autonomy, those not willing to wait between first and second operation, and those living far from the hospital. In the operating room we run two separate procedures for the two eyes. At the end of the surgeries the non dominant eye is patched, and the dominant eye is covered with a transparent shield, unless differently suggested by specific surgical factors

Results:

Only a part of the patients undergoing bilateral surgery accepted simultaneous surgery. We enrolled 16 patients out of the first 85 who were offered the new approach. In these surgeries we had no relevant complication, with no posterior capsule rupture. The patients perceived the bilateral surgery as a single procedure, but offering the quick recovery of bilateral vision. The hospital administration evaluated positively the reduced telephone, computer and paper work. The nurses outside the operating room did not report any difference between single or double procedures.

Conclusions:

Bilateral simultaneous cataract surgery was of advantage in our hospital. By increasing simultaneous surgery we increased patient satisfaction, we reduced administrative and nurse work, saved surgical time, and reduced the cost both for the hospital and for the society. FINANCIAL DISCLOSURE?: No