Assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment

Rolake O Alabi1, Zachary A Turnbull2, Peter G Coombs1, Yiyuan Wu3, Anton Orlin1, RV Paul Chan4, Szilard Kiss1, Donald J D’Amico1, Mrinali P Gupta1 1Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA; 2Department of Anesthesiology, Weill Cornell Medical College, N...

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Autores principales:	Alabi RO, Turnbull ZA, Coombs PG, Wu Y, Orlin A, Chan RVP, Kiss S, D'Amico DJ, Gupta MP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Vitreoretinal Surgery Retinal Detachment Preoperative Assessment Preoperative Medical Testing Adverse Medical Events Postoperative Systemic Adverse Events Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/0daf3b6563fa4a62b52b852eea365041
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spelling	oai:doaj.org-article:0daf3b6563fa4a62b52b852eea3650412021-12-02T02:28:46ZAssessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment1177-5483https://doaj.org/article/0daf3b6563fa4a62b52b852eea3650412019-09-01T00:00:00Zhttps://www.dovepress.com/assessing-the-value-of-preoperative-medical-clearance-in-patients-with-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Rolake O Alabi1, Zachary A Turnbull2, Peter G Coombs1, Yiyuan Wu3, Anton Orlin1, RV Paul Chan4, Szilard Kiss1, Donald J D’Amico1, Mrinali P Gupta1 1Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA; 2Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA; 3Division of Biostatistics and Epidemiology, Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, NY, USA; 4Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USACorrespondence: Mrinali P GuptaDepartment of Ophthalmology, Weill Cornell Medical College, 1305 York Avenue, New York, NY 10021, USATel +1 646 962 2217Fax +1 646 962 0600Email mrp9003@med.cornell.eduPurpose: To determine rates of intraoperative and postoperative systemic and ocular adverse events and establish the value of preoperative medical assessment in patients undergoing surgery for primary rhegmatogenous retinal detachment repair at a single academic center.Patients and methods: Retrospective cohort study of 185 patients undergoing surgery for repair of primary rhegmatogenous retinal detachment (RRD) at a single academic center. Medical records were reviewed for medical comorbidities, completion of preoperative medical examination, anesthesia used during surgery, intraoperative adverse medical events, intraoperative ocular complications, and systemic and ocular postoperative complications. The main outcome of interest was the association of comorbidities and preoperative medical evaluation with intraoperative and postoperative complications.Results: Approximately 48% of the patients presented with no medical comorbidities of interest. Formal preoperative evaluation by an independent medical provider was completed in 36% of the patients. Overall, intraoperative and postoperative systemic complications (5.7% and 1%, respectively) and intraoperative and postoperative ocular complications (0.5% for both) were uncommon. Patients with a history of chronic heart failure (OR 24.5, P=0.02) or who received general anesthesia (OR 9.56, P<0.001) had increased risk of having experienced any intraoperative or postoperative complication. No relationship between preoperative medical evaluation and intraoperative and postoperative complications was observed.Conclusion: Patients undergoing surgery for RRD repair presented with fewer medical comorbidities than previously reported in patients undergoing all vitreoretinal surgeries. Intraoperative and postoperative complications were uncommon and were increased in patients with chronic heart failure or who received general anesthesia. Complications were not significantly associated with preoperative evaluation by an independent medical provider.Keywords: vitreoretinal surgery, retinal detachment, preoperative assessment, preoperative medical testing, adverse medical events, postoperative systemic adverse eventsAlabi ROTurnbull ZACoombs PGWu YOrlin AChan RVPKiss SD'Amico DJGupta MPDove Medical PressarticleVitreoretinal SurgeryRetinal DetachmentPreoperative AssessmentPreoperative Medical TestingAdverse Medical EventsPostoperative Systemic Adverse EventsOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 1711-1718 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Vitreoretinal Surgery Retinal Detachment Preoperative Assessment Preoperative Medical Testing Adverse Medical Events Postoperative Systemic Adverse Events Ophthalmology RE1-994
spellingShingle	Vitreoretinal Surgery Retinal Detachment Preoperative Assessment Preoperative Medical Testing Adverse Medical Events Postoperative Systemic Adverse Events Ophthalmology RE1-994 Alabi RO Turnbull ZA Coombs PG Wu Y Orlin A Chan RVP Kiss S D'Amico DJ Gupta MP Assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment
description	Rolake O Alabi1, Zachary A Turnbull2, Peter G Coombs1, Yiyuan Wu3, Anton Orlin1, RV Paul Chan4, Szilard Kiss1, Donald J D’Amico1, Mrinali P Gupta1 1Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA; 2Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA; 3Division of Biostatistics and Epidemiology, Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, NY, USA; 4Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USACorrespondence: Mrinali P GuptaDepartment of Ophthalmology, Weill Cornell Medical College, 1305 York Avenue, New York, NY 10021, USATel +1 646 962 2217Fax +1 646 962 0600Email mrp9003@med.cornell.eduPurpose: To determine rates of intraoperative and postoperative systemic and ocular adverse events and establish the value of preoperative medical assessment in patients undergoing surgery for primary rhegmatogenous retinal detachment repair at a single academic center.Patients and methods: Retrospective cohort study of 185 patients undergoing surgery for repair of primary rhegmatogenous retinal detachment (RRD) at a single academic center. Medical records were reviewed for medical comorbidities, completion of preoperative medical examination, anesthesia used during surgery, intraoperative adverse medical events, intraoperative ocular complications, and systemic and ocular postoperative complications. The main outcome of interest was the association of comorbidities and preoperative medical evaluation with intraoperative and postoperative complications.Results: Approximately 48% of the patients presented with no medical comorbidities of interest. Formal preoperative evaluation by an independent medical provider was completed in 36% of the patients. Overall, intraoperative and postoperative systemic complications (5.7% and 1%, respectively) and intraoperative and postoperative ocular complications (0.5% for both) were uncommon. Patients with a history of chronic heart failure (OR 24.5, P=0.02) or who received general anesthesia (OR 9.56, P<0.001) had increased risk of having experienced any intraoperative or postoperative complication. No relationship between preoperative medical evaluation and intraoperative and postoperative complications was observed.Conclusion: Patients undergoing surgery for RRD repair presented with fewer medical comorbidities than previously reported in patients undergoing all vitreoretinal surgeries. Intraoperative and postoperative complications were uncommon and were increased in patients with chronic heart failure or who received general anesthesia. Complications were not significantly associated with preoperative evaluation by an independent medical provider.Keywords: vitreoretinal surgery, retinal detachment, preoperative assessment, preoperative medical testing, adverse medical events, postoperative systemic adverse events
format	article
author	Alabi RO Turnbull ZA Coombs PG Wu Y Orlin A Chan RVP Kiss S D'Amico DJ Gupta MP
author_facet	Alabi RO Turnbull ZA Coombs PG Wu Y Orlin A Chan RVP Kiss S D'Amico DJ Gupta MP
author_sort	Alabi RO
title	Assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment
title_short	Assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment
title_full	Assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment
title_fullStr	Assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment
title_full_unstemmed	Assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment
title_sort	assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/0daf3b6563fa4a62b52b852eea365041
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Assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment

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