Avaliação pré-operatória na cirurgia de catarata

Tallo, Fernando Sabia; Soriano, Eduardo; Alvarenga, Lênio Souza

doi:10.1590/s0004-27492007000400014

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…The literature has shown that for the vast majority of elderly patients with stable diseases, routine laboratory tests are a waste of time and financial resources 1,[3][4][5]12,[14][15][16]40 . In this study, about ten tests was performed per patient, and only the determination of blood glucose can be considered important for the assessment of the patients.…”

Section: Discussionmentioning

confidence: 99%

“…Since these are considered low-risk surgeries, there are no clear guidelines if a pre-anesthetic evaluation should be performed, as well as the time that it should be done [6][7][8][9] . Studies show different approaches to the selection of outpatients as well as the model for the realization of the PAA, the need for interdisciplinary assessments and complementary examinations [10][11][12][13][14][15][16] . Most surgeries are cataract correction, in predominantly elderly patients, and with a high prevalence of systemic comorbidities related to age.…”

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confidence: 99%

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The pre-anesthetic evaluation for ophthalmic surgery in the elderly is really necessary? The reality of a public hospital

Bisinotto¹,

Mesquita²,

Miziara³

et al. 2016

Revista Brasileira De Oftalmologia

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The pre-anesthetic evaluation for ophthalmic surgery in the elderly is really necessary? The reality of a public hospital

Bisinotto¹,

Mesquita²,

Miziara³

et al. 2016

Revista Brasileira De Oftalmologia

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Routine preoperative medical testing for cataract surgery

Keay

Lindsley

Tielsch

et al. 2009

Cochrane Database of Systematic Reviews

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Background Cataract surgery is practiced widely and substantial resources are committed to an increasing cataract surgical rate in developing countries. With the current volume of cataract surgery and the increases in the future, it is critical to optimize the safety and cost-effectiveness of this procedure. Most cataracts are performed on older individuals with correspondingly high systemic and ocular comorbidities. It is likely that routine preoperative medical testing will detect medical conditions, but it is questionable whether these conditions should preclude individuals from cataract surgery or change their perioperative management. Objectives (1) To investigate the evidence for reductions in adverse events through preoperative medical testing, and (2) to estimate the average cost of performing routine medical testing. Search strategy We searched CENTRAL, MEDLINE, EMBASE and LILACS using no date or language restrictions. We used reference lists and the Science Citation Index to search for additional studies. Selection criteria We included randomized clinical trials in which routine preoperative medical testing was compared to no preoperative or selective preoperative testing prior to age-related cataract surgery. Data collection and analysis Two review authors independently assessed abstracts to identify possible trials for inclusion. For each included study, two review authors independently documented study characteristics, extracted data, and assessed methodological quality. Main results The three randomized clinical trials included in this review reported results for 21,531 total cataract surgeries with 707 total surgery-associated medical adverse events, including 61 hospitalizations and three deaths. Of the 707 medical adverse events reported, 353 occurred in the pretesting group and 354 occurred in the no testing group. Most events were cardiovascular and occurred during the intraoperative period. Routine preoperative medical testing did not reduce the risk of intraoperative (OR 1.02, 95% CI 0.85 to 1.22) or postoperative medical adverse events (OR 0.96, 95% CI 0.74 to 1.24) when compared to selective or no testing. Cost savings were evaluated in one study which estimated the costs to be 2.55 times higher in those with preoperative medical testing compared to those without preoperative medical testing. There was no difference in cancellation of surgery between those with preoperative medical testing and those with no or limited preoperative testing, reported by two studies. Authors’ conclusions This review has shown that routine pre-operative testing does not increase the safety of cataract surgery. Alternatives to routine preoperative medical testing have been proposed, including self-administered health questionnaires, which could substitute for health provider histories and physical examinations. Such avenues may lead to cost-effective means of identifying those at increased risk of medical adverse events due to cataract surgery. However, despite the rare occurrence, adverse medical ...

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