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Anais Carniciu, Melissa Fazzari, Pauline Tabibian, Priti Batta, Ronald C Gentile, James Grendell, Collin Brathwaite, Nazanin Barzideh; Corneal abrasion following anesthesia for non-ocular surgical procedures. A case-control study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3057.
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To identify and characterize the risk factors associated with corneal abrasions following anesthesia for non-ocular surgical procedures at a single institution.
The medical, surgical, and anesthesia records of consecutive patients with a corneal abrasion following anesthesia that underwent ophthalmology consultation between 6/2011 and 11/2013 were reviewed. Data collected included demographics, medical history, duration and type of surgery, and patient positioning during surgery. Similar data was collected for a comparative group of age-matched controls from the same time period. Analysis was performed using an age-stratified logistic regression model evaluating the association between corneal abrasion occurrence and gender, diabetes status, duration of surgery, surgical position (supine vs. lateral vs. prone), and type of procedure (head and neck vs. other procedures). Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated as a measure of the association between corneal abrasions and the variables tested.
Thirty-seven consecutive patients with post-operative corneal abrasions were identified over the 2.5-year period and compared to 101 age-matched controls (202 eyes). Corneal abrasions were associated more often with procedures lasting 3 hours or more. Forty-eight percent of the patients with a corneal abrasion had surgeries lasting ≥ 3 hours compared to 18% of the patients in the control group without a corneal abrasion. The adjusted odds of a corneal abrasion is 5.3 times greater for patients having surgery for ≥ 3 hours (univariate OR=4.2, 95% CI:1.9-9.5, p<0.001). Gender, diabetes status, surgical procedure or position were not found to be associated with the occurrence of a corneal abrasion.
Longer duration of the surgical procedure is a risk factor for a corneal abrasion. Surgeons and anesthesiologists should be aware of this risk factor and take extra precautions to prevent this complication, especially when surgery takes longer than three hours.
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