Day-case cataract surgery

Abstract

This is a report of prospective trial to compare day-case and inpatient surgery for senile cataract. In this district, cataract extraction is usually delayed until bilateral surgery is warranted. Both eyes are then operated upon a week or so apart. Such patients are ideal for comparing the results of day-case and in-patient management, since if one eye is done by each method, there is a perfect match for age, sex, general medical health, and domestic circumstances. During a period of 27 months, 138 patients aged 50 years or over were included in this trial. Five more patients were dropped from the trial and 78 other cataract operations were performed outside the trial for various reasons. For those included in the trial, the eye with the worse vision was operated upon first and patients were randomly allocated to have this eye managed as a day-case or an inpatient. All these operations were performed by the same surgeon (D.B.). Details of events during the 48 hours after surgery were kept (M.J.T.) separate from the hospital records used for follow-up (R.M.I.) and refraction (R.K.T.), which were therefore done without knowledge of how each eye had been managed. Visual acuity and intraocular pressure were recorded 2 to 3 months and one year after operation for those in the trial. Visual acuity alone was recorded at 2 to 3 months for those not in the trial. It is concluded that provided the patients are carefully selected, the advantages of day-case surgery outweigh the disadvantages both for patient management and considerations of economy.