Office-Based Cataract Surgery Safe and Effective
by: Jennifer Garcia
Cataract surgery can be performed safely in the office setting without sacrificing efficacy, according to a new study published online January 21 and in the April issue of Ophthalmology.
“In the last few decades, stepwise technologic advances in phacoemulsiﬁcation and foldable [intraocular lenses] allowed cataract surgery to move to the ambulatory setting,” write Tsontcho Ianchulev, MD, MPH, from the University of California, San Francisco, and colleagues.
“Cataract surgery is now a safe outpatient procedure, and our experience with more than 21 000 cases extends these ﬁndings to the ofﬁce-based setting,” the authors note.
As part of the largest population-based study thus far to evaluate the safety and efficacy of in-office cataract surgeries, the researchers reviewed data from 21,501 consecutive procedures (13,507 patients) performed in minor procedure rooms between 2011 and 2014 at three large integrated healthcare centers (Kaiser Permanente Colorado). The mean patient age was 72.6 years, and phacoemulsification with intraocular lens implantation was performed in 99.9% of cases. The primary outcomes assessed were best-corrected visual acuity and the incidence of perioperative adverse events.
The authors found that among 99.7% of the cohort, postoperative mean best corrected visual acuity measured 0.14 ± 0.26 logarithm of the minimum angle of resolution units (equivalent to 20/28 Snellen).
Overall, intraoperative adverse events included capsule rupture or tear in 119 cases (0.55%) and vitreous loss in 73 cases (0.34%). Postoperative adverse events included iritis/uveitis in 330 eyes (1.53%), retinal detachment within 90 days of surgery in 30 cases (0.14%), and cystoid macular edema in six eyes (0.03%). A second surgery was required within 6 months in 150 eyes (0.70%). The authors hypothesize that use of intracameral antibiotic prophylaxis was likely the reason no cases of postoperative endophthalmitis were reported in this cohort…….
Read more: http://www.medscape.com/viewarticle/862309