Possibilities and Limitations of the Surgery of the Eye’s Posterior Segment
under the Outpatient Conditions
Doležalová J., Karel I., Záhlava J., Lešták J.
Oční klinika JL, Nové Butovice, vedoucí prim. MUDr. Ján Lešták, CSc. |
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Summary:
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
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