Possibilities and Limitations of the Surgery of the Eye’s Posterior Segment under the Outpatient Conditions

Overview

The goal of this article was to analyze possibilities of the vitreoretinal surgery under the outpatient conditions and to set its limitations.

During the period January 1st -⁠ September 30th, 2004, there were performed 95 operations of 78 eyes in 77 patients. Number of men and women was practically equal; the age ranged 17–86 years (average 62.6 years). We operated on mostly the retinal detachment.

These as well as other procedures, including also the extreme surgery with relaxing retinectomy, extraction of the subretinal tractions and membranes, silicone oil implantation or extraction, or operations combined with the cataract surgery and intraocular lens implantation. Surgeries were performed under local anesthesia combined with analgesia and sedation introduced by anesthesiologist, who was always present and monitored the patient. Surgeries were performed by means of A.V.I. lens and Biom as well, with the assistance of a doctor, and later on, solely of a theatre nurse. The surgeon performed the operations by herself and long-term followed up the patients. The variety of vitreoretinal procedures did not differ from those performed at the departments of ophthalmology at university hospitals. The retinal detachment surgery was more often performed by means of cryosurgical procedure than pars plana vitrectomy undoubtedly because of early recognition of the beginning detachment.

All vitreoretinal procedures may be performed on the outpatient basis. The only limiting factors are the physical condition of the patient and an acute ocular disease demanding urgent surgery in a facility with permanent service.

Vitreoretinal surgery in outpatient facility performed under local anesthesia is well tolerated by the patients and the postoperative care under outpatient conditions is of equal quality as in inpatient facilities.

Key words:
Outpatient surgery (one day surgery), vitreoretinal disease, psychological preparation