Unplanned Return to the Operating Room After Cataract Surgery

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-03-11 DOI:10.1016/j.ajo.2025.03.014

Mallory K. Suazo , Malik Muhammad Hamza Khan , Anam Akhlaq , Muhammad Ali , Oliver D. Schein , Fasika A. Woreta

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引用次数: 0

Abstract

PURPOSE

To determine the rate of unplanned return to the operating room (OR) within 90 days of cataract surgery and to identify the most common preoperative and intraoperative risk factors.

DESIGN

Retrospective case-control study.

SUBJECTS AND CONTROLS

Patients aged ≥40 years undergoing cataract surgery at the Wilmer Eye Institute between 2019 and 2022 with at least 90 days of postoperative follow-up were included. Patients with return to the OR for a reason other than a postoperative complication of cataract surgery in the same eye were excluded. For each case, a time-matched control (cataract surgery within 1 month of the case's surgery) was selected using a random number generator.

METHODS

The chi-squared test was used for categorical variables, the student's t-test for continuous variables, and the multivariable logistic regression analysis to assess for associated preoperative and intraoperative factors.

MAIN OUTCOME MEASURES

The main outcomes included the rate and the most common reasons for unplanned return to the OR as well as the odds ratios of associated preoperative and intraoperative variables.

RESULTS

Among 32,480 eyes, 175 eyes (0.54%) had an unplanned return to the OR within 21 ± 21 days of cataract surgery. The most common reason was retained lens fragments in 88 eyes (50%). Patients with an unplanned return to the OR had a worse mean best-corrected visual acuity preoperatively (Snellen equivalent of ∼20/100 for cases vs 20/50 for controls, p-value < .001) and at last follow-up (cases 20/50, controls 20/30, p-value < .001). There were significantly higher odds of an unplanned return to the OR for patients undergoing complex cataract surgery (odds ratio, 1.80; 95% CI, 1.06-3.05) and for patients with prior tamsulosin use (odds ratio, 2.00; 95% CI, 1.09-3.69).

CONCLUSIONS

Patients undergoing complex cataract surgery and those with prior tamsulosin use had significantly higher odds of unplanned return to the OR. Monitoring rates of unplanned return to the OR at the institutional and national levels by using national clinical registries or a multicenter study is needed to assist in quality monitoring and to improve patient surgical outcomes.

查看原文本刊更多论文

白内障手术后意外返回手术室。

目的：了解白内障手术后90天内意外返回手术室的发生率，并找出最常见的术前和术中危险因素。设计：回顾性病例对照研究。受试者和对照组：纳入年龄bb0 = 40岁的患者，于2019-2022年间在Wilmer眼科研究所接受白内障手术，术后随访至少90天。排除因同眼白内障手术术后并发症以外的原因返回手术室的患者。对于每个病例，使用随机数发生器选择时间匹配的对照（病例手术后1个月内进行白内障手术）。方法：分类变量采用卡方检验，连续变量采用学生t检验，多变量logistic回归分析评估术前、术中相关因素。主要结局指标：主要结局包括意外返回手术室的比率和最常见的原因，以及术前和术中相关变量的优势比。结果：32,480只眼中，175只眼（0.54%）在白内障手术后21±21天内意外返回手术室。最常见的原因是晶状体碎片残留，88只（50%）眼。意外返回手术室的患者术前平均最佳矫正视力（BCVA）较差（Snellen等效约为20/100，对照组为20/50），p=结论：接受复杂白内障手术的患者和先前使用过坦索罗辛的患者意外返回手术室的几率明显更高。需要利用国家临床登记或多中心研究，在机构和国家层面监测计划外重返手术室的比率，以协助质量监测和改善患者的手术结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.