Issue: January 2016
Perspective from George Beiko, BM, BCh, FRCSC
November 16, 2015
2 min read
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Speaker: Bilateral, same-day cataract surgery poses no additional risk to patients

Issue: January 2016
Perspective from George Beiko, BM, BCh, FRCSC
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LAS VEGAS — Bilateral, same-day cataract surgery should not pose any additional undue risks to the patient than sequential cataract surgery, according to a presentation here.

“Bilateral, same-day cataract surgery offers convenience and time saving for patients through reduced time off work, fewer appointments, less travel and concurrent recovery of eyes. Costs savings may also be realized to payers, employers and employees,” Neal H. Shorstein, MD, said at the American Academy of Ophthalmology annual meeting.

To assess the risk for bilateral, same-day cataract surgery, a failure modes and effects analysis analyzed the risk of endophthalmitis, toxic anterior segment syndrome (TASS) and unintended IOL implantation based on lens type and power.

More than 25 clinicians and experts examined 4,754 bilateral cases from 21 Northern California Eye Department centers undertaken between 2009 and 2014.

There were no instances of bilateral endophthalmitis, one instance of unilateral endophthalmitis, one instance of unintended IOL implantation in one eye, and no instances of TASS. There was one instance of dilution error in onsite compounding of cefuroxime, and no instances of manufacturer recalls of pertinent medicines or products.

Shorstein said work is ongoing to train surgeons and staff in order to maintain a high degree of reliability.

“This is accomplished through instilling everyone with preoccupation with failure, promoting surgeon sensitivity to the role of others including nurses and staff, cultivating nimbleness and resilience in the workplace to unexpected situations, and moving toward standardization and simplification wherever possible,” he said. — by Kristie L. Kahl

Reference:

Shorstein NH. Bilateral, same-day cataract surgery: risk analysis and recommendations in a Northern California Eye Department. Presented at: American Academy of Ophthalmology annual meeting. Nov. 15, 2015; Las Vegas.

Disclosure: Shorstein reports no relevant financial disclosures.