Rate, reasons, and associated factors of ophthalmic unplanned reoperations during a single hospitalization: a ten-year retrospective case-control study at a tertiary referral center in China

Background: Unplanned reoperations exert burdens on patients and present challenges in the management of surgical cases. The present study aimed at investigating the features and risk factors of unplanned reoperations following ophthalmic surgeries during the same hospitalization. Materials and Methods: This retrospective case-control study reviewed 41,662 hospitalization records for ophthalmic surgeries performed between February 2014 and December 2023 in a tertiary referral center. Unplanned reoperations during the same hospitalization for surgeries indicated for cataract, glaucoma, retinal detachment (RD), silicone oil removal (SOR) after RD repair, and vitreous hemorrhage (VH) were included. Each unplanned reoperation record was matched with a control undergoing similar procedures performed by the same surgeon within one month. Results: The study included 236 unplanned reoperations, constituting 0.72% of all the five types of ophthalmic surgeries. The mean interval from original surgeries to unplanned reoperations was 5.32 days. The most common reoperation reasons were flat anterior chambers (30.9%) for glaucoma group, intraocular lens dislocation (49.4%) for cataract group, unrepaired RD (47.1%) for RD group, and VH recurrence (27.8%) for VH group. Poorer preoperative visual acuity (VA) was associated with an increased reoperation risk after glaucoma and SOR procedures (P < 0.05), while decreased postoperative VA significantly correlated with unplanned reoperations in patients undergoing glaucoma, cataract, and RD repair surgeries (P < 0.05). The reoperation risk for RD repair surgeries was associated with the comorbidity of retinal vascular diseases (P = 0.018). Conclusion: Ophthalmic surgeons might perform postoperative monitoring for patients with poorer pre- and postoperative VA and RD patients with retinal vascular disorders.