Eyeworld

EW CATARACT 43 October 2016 macular edema with 30-day readmis- sion to the hospital should be ad- dressed with patients, and surgeons should take steps to lower this risk, such as by offering a longer course of nonsteroidal and steroidal drops postop, Dr. Shukla said. One finding that raised a red flag was the significant association found between a history of COPD and 30-day postop mortality—even if the mortality did not have a direct relationship to cataract surgery. "Patients, anesthetists, and ophthal- mic surgeons should consider this additional factor when weighing the risks and benefits of elective surgery in patients with COPD," Dr. Daly said. "Preoperative consultation with medical, pulmonary, and/or cardiac physicians, more rigorous optimization before surgery, and closer follow-up after surgery could help decrease this risk." David Mannino, MD, professor of medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kentucky, Lexing- ton, was not surprised that COPD patients had a greater number of deaths within 30 days after surgery. However, he pointed out that the total number of deaths was low. Still, he thinks this research sheds some light on COPD. "It highlights the reality that it's a chronic condition. There's a perception that it's not taken as seriously as other diseases," Dr. Mannino said. In fact, there are some studies that show a greater number of deaths 90 days after hos- pital admission in COPD patients versus those with heart disease. Dr. Mannino supports the idea that COPD patients be cleared for any kind of surgery by a pulmonary specialist, if they have one. "It also appears that patients undergoing cataract surgery in the VA are generally sicker, and such patients would benefit from a higher level of care and team approach with their primary care and medical care teams," Dr. Shukla added. EW Reference 1. Payal AR, et al. American Society of Anesthesiologists classification in cataract surgery: Results from the Ophthalmic Surgery Outcomes Data Project. J Cataract Refract Surg. 2016;42:972–982. Editors' note: The physicians have no financial interests related to their comments. The views expressed by Dr. Daly do not necessarily reflect the position or policy of the United States Department of Veterans Affairs or the U.S. Government. Contact information Daly: mary.daly2@va.gov Mannino: dmmann2@email.uky.edu Shukla: anitanathanshukla@gmail.com Call your local BVI sales rep or customer service at 1.866.906.8080 www.beaver-visitec.com Thinking about Switching to Single-use Instruments? S i n g l e - U s e S o l u t i o n s 2 The Visitec® single-use portfolio can benefi t you, your patients and your hospital. • Improved operating room effi ciency • Consistently excellent product performance • Enhanced patient safety Beaver-Visitec International, Inc. 411 Waverley Oaks Road, Waltham, MA 02452 Tel: 1.866.906.8080 Fax: 1.866.906.4304 www.beaver-visitec.com BVI, BVI Logo and all other trademarks are property of Beaver-Visitec International (BVI) © 2016 BVI Visit us at AAO Booth 2515

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