Journal francais d'ophtalmologie · 2025
Cataract surgery without preanesthetic consultation: A 2-year retrospective study.
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Cayzac V, Bordes J, Valero B, Voisin H, Sagnard M, Bertin J, David T, El Chehab H
Аннотация
PURPOSE: Cataract surgery is the most commonly performed procedure in the world. However, certain perioperative modalities remain controversial, and the necessity of systematic performance of a preanesthetic consultation is gradually being questioned. The goal of this study was to investigate the anesthetic and surgical safety of performing cataract surgeries under topical or sub-Tenon's anesthesia without prior preanesthetic consultation.
METHODS: Thus, we conducted a retrospective study at Sainte-Anne Military Teaching Hospital (Toulon, France) over the period from January 1, 2021, to December 31, 2022, including all patients admitted to the operating room for a phacoemulsification procedure performed under topical or sub-Tenon's anesthesia without prior preanesthetic consultation. Patients were referred to this simplified care pathway in the absence of: predictable surgical difficulties, significant anxiety, risk of agitation or claustrophobia, communication difficulties, lack of cooperation, difficulties in maintaining a motionless supine position, coughing or severe dyspnea or severe allergic history. The eligible patients for this care pathway were selected by the surgeon based on a list of indications. The occurrence of systemic or surgical complications, drug interventions, calls to the anesthesiologist, or unplanned hospitalization in the immediate postoperative period was recorded.
RESULTS: One thousand procedures were performed on 654 patients. No major systemic complications were recorded. Surgical complications occurred in 27 procedures (2.7%). Medication was administered to the patient intraoperatively during 413 (41.3%) procedures, mostly antihypertensive drugs (33.1%) and sedatives (11.5%). Aside from drug prescription, 9 calls (0.9%) were made to the anesthesiologist. There were no unplanned hospitalizations in the immediate postoperative period.
CONCLUSION: In our series, performing phacoemulsification procedures under topical or sub-Tenon's anesthesia without prior preanesthetic consultation has shown anesthetic and surgical complication rates comparable to those reported in the literature. Prospective comparative studies are needed to confirm the non-inferiority of this care pathway and to generalize its practice.
METHODS: Thus, we conducted a retrospective study at Sainte-Anne Military Teaching Hospital (Toulon, France) over the period from January 1, 2021, to December 31, 2022, including all patients admitted to the operating room for a phacoemulsification procedure performed under topical or sub-Tenon's anesthesia without prior preanesthetic consultation. Patients were referred to this simplified care pathway in the absence of: predictable surgical difficulties, significant anxiety, risk of agitation or claustrophobia, communication difficulties, lack of cooperation, difficulties in maintaining a motionless supine position, coughing or severe dyspnea or severe allergic history. The eligible patients for this care pathway were selected by the surgeon based on a list of indications. The occurrence of systemic or surgical complications, drug interventions, calls to the anesthesiologist, or unplanned hospitalization in the immediate postoperative period was recorded.
RESULTS: One thousand procedures were performed on 654 patients. No major systemic complications were recorded. Surgical complications occurred in 27 procedures (2.7%). Medication was administered to the patient intraoperatively during 413 (41.3%) procedures, mostly antihypertensive drugs (33.1%) and sedatives (11.5%). Aside from drug prescription, 9 calls (0.9%) were made to the anesthesiologist. There were no unplanned hospitalizations in the immediate postoperative period.
CONCLUSION: In our series, performing phacoemulsification procedures under topical or sub-Tenon's anesthesia without prior preanesthetic consultation has shown anesthetic and surgical complication rates comparable to those reported in the literature. Prospective comparative studies are needed to confirm the non-inferiority of this care pathway and to generalize its practice.