Key result
Preoperative evaluation before ophthalmologic surgery can delay procedures without improving outcomes, as evidence suggests these surgeries carry very little perioperative risk.
Why the study?
Does routine preoperative evaluation improve outcomes or reduce perioperative risk in patients undergoing ophthalmologic surgery?
Does routine preoperative evaluation improve outcomes or reduce perioperative risk in patients undergoing ophthalmologic surgery?
Routine preoperative evaluation for ophthalmologic surgery delays procedures without improving outcomes, given the extremely low perioperative cardiovascular risk.
EditorialsMay 2022Preoperative Evaluation Can Delay Ophthalmologic Surgery Without Improving OutcomesBobbieJean Sweitzer, MDBobbieJean Sweitzer, MDInova Health, Falls Church, and Department of Medical Education, University of Virginia, Charlottesville, VirginiaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-0709 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Ophthalmologic procedures are among the most common surgeries performed. In the United States and most developed countries, the vast majority of ophthalmologic procedures are done with local anesthesia with minimal sedation as outpatient procedures. Most patients having eye procedures are elderly with many comorbidities. Evidence suggests that ophthalmologic surgeries carry very little perioperative risk (1). However, patients are commonly sent for preoperative testing and evaluation before these surgeries. In this issue, Sen and colleagues contribute further to what is almost irrefutable evidence of the safety of ophthalmologic procedures (2).Using 2 large patient registries in Norway and Sweden, they identified ...References1. Fong CS, Mitchell P, Rochtchina E, et al. Visual impairment corrected via cataract surgery and 5-year survival in a prospective cohort. Am J Ophthalmol. 2014;157:163-170.e1. [PMID: 24161249] doi:10.1016/j.ajo.2013.08.018 CrossrefMedlineGoogle Scholar2. Sen A, Gémes K, Stålhammar G, et al. Risk for acute myocardial infarction after ophthalmologic procedures. Ann Intern Med. 2022;175:628-33. doi:10.7326/M20-6618 LinkGoogle Scholar3. Hashemi H, Pakzad R, Yekta A, et al. Global and regional prevalence of age-related cataract: a comprehensive systematic review and meta-analysis. Eye (Lond). 2020;34:1357-1370. [PMID: 32055021] doi:10.1038/s41433-020-0806-3 CrossrefMedlineGoogle Scholar4. Sweitzer B, Rajan N, Schell D, et al. Preoperative care for cataract surgery: the Society for Ambulatory Anesthesia position statement. Anesth Analg. 2021;133:1431-1436. [PMID: 34784329] doi:10.1213/ANE.0000000000005652 CrossrefMedlineGoogle Scholar5. Schein OD, Katz J, Bass EB, et al. The value of routine preoperative medical testing before cataract surgery. Study of Medical Testing for Cataract Surgery. N Engl J Med. 2000;342:168-75. [PMID: 10639542] doi:10.1056/NEJM200001203420304 CrossrefMedlineGoogle Scholar6. Chen CL, Lin GA, Bardach NS, et al. Preoperative medical testing in Medicare patients undergoing cataract surgery. N Engl J Med. 2015;372:1530-8. [PMID: 25875258] doi:10.1056/NEJMsa1410846 CrossrefMedlineGoogle Scholar7. Thilen SR, Treggiari MM, Lange JM, et al. Preoperative consultations for Medicare patients undergoing cataract surgery. JAMA Intern Med. 2014;174:380-8. [PMID: 24366269] doi:10.1001/jamainternmed.2013.13426 CrossrefMedlineGoogle Scholar8. Chen CL, McLeod SD, Lietman TM, et al. Preoperative medical testing and falls in Medicare beneficiaries awaiting cataract surgery. Ophthalmology. 2021;128:208-215. [PMID: 32926912] doi:10.1016/j.ophtha.2020.09.013 CrossrefMedlineGoogle Scholar9. Hartle A, McCormack T, Carlisle J, et al. The measurement of adult blood pressure and management of hypertension before elective surgery: joint guidelines from the Association of Anaesthetists of Great Britain and Ireland and the British Hypertension Society. Anaesthesia. 2016;71:326-37. [PMID: 26776052] doi:10.1111/anae.13348 CrossrefMedlineGoogle Scholar10. Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;130:2215-45. [PMID: 25085962] doi:10.1161/CIR.0000000000000105 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Inova Health, Falls Church, and Department of Medical Education, University of Virginia, Charlottesville, VirginiaDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-0709.Corresponding Author: BobbieJean Sweitzer, MD, Inova Health, 3300 Gallows Road, Falls Church, VA 22042; e-mail, BobbieJean.[email protected]org.This article was published at Annals.org on 22 March 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRisk for Acute Myocardial Infarction After Ophthalmologic Procedures Abhijit Sen , Katalin Gémes , Gustav Stålhammar , Christer Svensen , Per Tornvall , Magnus Jonsson , Torunn Varmdal , Birger Henning Endreseth , Imre Janszky , and Jette Möller Metrics May 2022Volume 175, Issue 5Page: 747-748KeywordsAdverse eventsAnesthesiaCataract surgeryCataractsOphthalmologySurgery ePublished: 22 March 2022 Issue Published: May 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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BobbieJean Sweitzer (2022) conducted an editorial in Ophthalmologic surgery. Preoperative evaluation was evaluated. Preoperative evaluation before ophthalmologic surgery can delay procedures without improving outcomes, as evidence suggests these surgeries carry very little perioperative risk.
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