Aims-To assess the outcome, in terms of completion of admission and complication rates, for two series of patients undergoing open lacrimal surgery, one group planned for a day case admission and the other planned for inpatient stay. Methods-A retrospective analysis of case notes was performed for 200 patients planned to have day case admission (for 209 open lacrimal operations) and the details compared with those for 200 inpatient admissions (for 228 lacrimal procedures) during the same period of study. The success rates for surgery were not examined. Results-9% of planned day cases required overnight admission, 5.5% for medical reasons and 3.5% for social or administrative reasons. There was a similar incidence of postoperative complications in planned day cases and inpatients, although 6% of day case patients developed postoperative cellulitis, compared with 1.3% of the inpatients (p= 0.01). Overall, the incidence of cellulitis was greater in cases complicated by intraoperative haemorrhage (p < 0.05) or the use of absorbable nasal packing (p < 0.0001). A similar number of patients in each group attended the accident and emergency department before the planned first postoperative clinic visit.
Conclusion-Patients undergoing openlacrimal surgery can be safely managed as day cases if carefully selected for suitability on social and medical criteria. The use of general anaesthesia is not, in itself, a contraindication to day case lacrimal surgery. (Br J Ophthalmol 1998;82:392-396) Following recommendations by the Audit Commission, 1 increasing numbers of cataract and squint operations are performed as day case or ambulatory procedures. In contrast, few surgeons perform external dacryocystorhinostomy (DCR) as a day case procedure and, in any such published series, the surgery is usually performed under local anaesthesia or assisted local anaesthesia. In this paper we present a retrospective analysis of our experience with day case open lacrimal surgery performed, in most cases, with general anaesthesia. The success rate for the surgery is not examined, as this paper is specifically intended to address the outcome in terms of completion of admission episodes and the rate of postoperative complications.
Patients and methodsPatients undergoing open lacrimal surgery over a 25 month period to January 1995 were identified using the operating theatre records and the hospital computer administration system. Two hundred consecutive day case admissions and 200 inpatient admissions were selected for comparison. The inpatient group was chosen by selecting, for each day case operation, the next inpatient procedure on the same operating list or, if no inpatient DCR was available or the case had already been selected, the next unselected inpatient DCR was chosen. At Moorfields Eye Hospital, there are several lacrimal theatre lists each week, each being allocated to a particular grade of surgeon, and the method for choosing inpatient "controls" was such that, where possible, each day case and "control" was treated by t...
