Risks factors and regression model for risk calculation of anesthesiologic intervention in topical and intracameral cataract surgery

Abstract

No author has a financial or proprietary interest in any material or method mentioned.

Safety and comparative costs of preoperative assessments for cataract surgery: traditional mandatory assessment versus a novel graded assessment system

“…The safety of our approach is further reinforced by the low overall rate of complications in our study group, which does not exceed those presented in other large-scale studies of the systemic risk of cataract surgery. 16,17 In our counterfactual design, we calculated that the rate of complications would be lower if all patients had a preoperative assessment. This was unsurprising, as we assumed the rate of complications in this group would be zero if implementation did not occur.…”

“…We developed our questionnaire using information from the literature on complications following cataract surgery, 4,16,17 with refinement based on consensus from members of the departments of anesthesia and ophthalmology. The quantitative readability of the questionnaire was written at a fifth grade reading level (Fry formula), which is consistent with the healthcare literacy recommendations.…”

“…A minimum sample size of 3,200 patients was required to achieve a margin of error B 1% for all complication rates, assuming a range of possible incidences of 0.1-10%. 16,17 This sample size was also required to achieve an upper confidence limit of no greater than 0.1%, assuming a point estimate of 0%.…”

“…14,15 Additionally, many centres have entirely eliminated preoperative assessment before cataract surgery, either for select patients or for this patient population as a whole. Furthermore, centres still conducting preoperative assessments may feel pressure to eliminate them based on historically low complication rates 4,5,10,[16][17][18] and the large volume of pending cases. Even so, the evidence supporting elimination of assessment is anecdotal, and primary care H&Ps remain the standard of care in most areas.…”

Patient considerations in cataract surgery – the role of combined therapy using phenylephrine and ketorolac

“…Since not all cataract procedures have the same degree of complexity, a complete presurgical evaluation might benefit from scoring systems, like the one developed by Muhtaseb et al 22 that allows the surgeon to categorize patients according to their risk of intraoperative complications, or the regression model proposed by Moreno-Montañés et al 23 aimed to identify high-risk patients, thus allowing the cataract surgeon to anticipate potential difficulties in challenging cases.…”