Abstract
Purpose :
To evaluate the efficacy of preoperative telephone medical clearance for patients undergoing ophthalmic surgery in an ambulatory surgical center.
Methods :
A retrospective cohort study was performed at a single ophthalmic ambulatory surgical center that included all patients who were considered for surgery in a consecutive twelve- month period, August 1st, 2018 to July 31st, 2019. All patients receiving non-laser ophthalmic surgery are initially screened by phone. If their condition is not optimal for surgery then the patient needs a note of medical clearance from their primary care physician or specialist medical doctor. The patients who failed the telephone screening were then analyzed for the medical reasons of not passing the telephone screening. Also, same day cancellations of surgery after preoperative history and physical at the surgical center were analyzed.
Results :
A total of 6,205 non laser surgical procedures were performed in a consecutive twelve- month period and received telephone medical screening. Of this number,127 (2.05%) patients were referred out for medical clearance. The most common medical conditions that prevented patients from passing telephone screening were a cardiovascular event (69.2%), respiratory (9.4%), neurological (8.7%), gastrointestinal (1.5%), and anxiety (0.7%), and other (10.2%).
There were 12 out of 6,205 patients (0.19%) that had same day cancellations due to their medical condition on the day of surgery. The medical conditions were as follows: cardiovascular (66.7%), anxiety (25%), respiratory (8.3%), gastrointestinal (0%), neurological (0%) and other (0%). One of these 12 same day cancelled cases were among those 127 patients who required preoperative medical clearance after failing telephone screening.
Conclusions :
Medical condition telephone screening appears to be a reasonable method to ensure patients are medically stable candidates for ophthalmic surgery. Preoperative medical clearance was required in 2.05% who failed phone screening, and same day cancellation of surgery was 0.19%, leaving approximately 97.76% of patients having surgery without needing medical clearance from their physician or medical specialist. Cardiovascular conditions were a common cause of referral for both medical clearance preoperatively and for same day surgery cancellation.
This is a 2020 ARVO Annual Meeting abstract.