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Post-op day one and subsequent management of vitrectomy patients

Session Details

Session Title: Vitreoretinal Surgery I

Session Date/Time: Thursday 26/09/2013 | 11:00-12:30

Paper Time: 11:08

Venue: Hall 3 (Level 0)

First Author: A.Fernando SRI LANKA

Co Author(s):    C. Gorman              

Abstract Details

Purpose:

To determine whether Post op Day 1 review actively changed the management of patients in terms of; 1) Deviation from the standard protocol 2) Adjustment in medication 3) Surgical intervention

Setting:

Cardiff Eye Unit, University Hospital of Wales, Cardiff, Wales. UK

Methods:

Prospective, consecutive, observational study. Sample size-121 vitrectomies (23G- 87%, 20G- 13%) Consecutive vitrectomies performed/ personally supervised by a single surgeon was assessed over a period of 2 weeks. All patients were reviewed on the day after surgery (D1) and examination findings noted. If intra-ocular pressure (IOP), anterior segment and posterior segment findings were as expected, they were seen 2 weeks after surgery. Any patients with adverse/ altered findings were reviewed at a shorter interval and any intervention was documented. Analysis was made of the adverse findings and how they progressed over the first two weeks.

Results:

1.) Incidence of high IOP (>30mmHg) was1.7%, much less than the published data and was exclusively found with expansile gases. 2.) D1 low pressure (IOP<10mmHg) was 14% and exclusively found in 23G surgery. All recovered without any intervention. 3.) D1 review helped in prompt identification and treatment of certain adverse findings (eg- increased inflammation), possibly preventing long term complications.

Conclusions:

1.) D1 review was helpful in identifying adverse effects and carrying out appropriate treatment. 2.) It may be possible, in a carefully selected, small number of patients without gas tamponade to fore-go the D1 review, but a laid out care plan and protocol has to be formulated.

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