<p>Assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment</p>

Abstract

Purpose To determine rates of intraoperative and postoperative systemic and ocular adverse events and establish the value of preoperative medical assessment in patients undergoing surgery for primary rhegmatogenous retinal detachment repair at a single academic center. Patients and methods Retrospective cohort study of 185 patients undergoing surgery for repair of primary rhegmatogenous retinal detachment (RRD) at a single academic center. Medical records were reviewed for medical comorbidities, completion of preoperative medical examination, anesthesia used during surgery, intraoperative adverse medical events, intraoperative ocular complications, and systemic and ocular postoperative complications. The main outcome of interest was the association of comorbidities and preoperative medical evaluation with intraoperative and postoperative complications. Results Approximately 48% of the patients presented with no medical comorbidities of interest. Formal preoperative evaluation by an independent medical provider was completed in 36% of the patients. Overall, intraoperative and postoperative systemic complications (5.7% and 1%, respectively) and intraoperative and postoperative ocular complications (0.5% for both) were uncommon. Patients with a history of chronic heart failure (OR 24.5, P =0.02) or who received general anesthesia (OR 9.56, P <0.001) had increased risk of having experienced any intraoperative or postoperative complication. No relationship between preoperative medical evaluation and intraoperative and postoperative complications was observed. Conclusion Patients undergoing surgery for RRD repair presented with fewer medical comorbidities than previously reported in patients undergoing all vitreoretinal surgeries. Intraoperative and postoperative complications were uncommon and were increased in patients with chronic heart failure or who received general anesthesia. Complications were not significantly associated with preoperative evaluation by an independent medical provider.

The incidence, risk factors, management and prognosis of postoperative systemic complications after ophthalmic surgery: a retrospective study at a tertiary, academic referral hospital over a decade

“…In this study, several risk factors were identified for postoperative systemic complications. General anaesthesia and comorbidities of chronic heart failure were significant predictors for systemic adverse events, which were consistent with the results of the previous studies found in PPV surgery [ 7 , 8 ]. We also found that patients with worse ADL grading, patients diagnosed with PIOL, and PPV were risk factors for systemic complications.…”

“…For cases undergoing surgery for primary rhegmatogenous RD, Alabi et al. [ 8 ] reported intraoperative and postoperative systemic complications of 5.7% (11/193) and 1% (2/193), respectively. McCannel et al.…”

Preoperative telephone medical clearance for ophthalmic surgeries

“…Other studies on preoperative clearance for ophthalmic surgery arrived at a similar conclusion. 4,5 A recent meta-analysis concluded that those who underwent routine preoperative medical testing had similar results to those who did not undergo routine preoperative medical testing. 6 Study limitations include being a retrospective study with only 1 privately owned ophthalmic ASC in a single geographic community.…”