Results of inpatient and outpatient cataract surgery. A historical cohort comparison.
OBJECTIVE
The transition from inpatient to outpatient cataract surgery during the last decade was not accompanied by prospective investigation of its effect on visual outcomes or surgical complications. The authors performed this study to assess the impact of this transition on surgical results.


METHODS
The authors reviewed 600 extracapsular cataract extractions performed by 4 experienced ophthalmic surgeons during a 36-month period; in 300 cases, patients were hospitalized after surgery (inpatient group), and, in 300 cases, patients were never hospitalized (outpatient group). The same surgical techniques were used in all cases. Visual outcome and rates for operative and postoperative complications were compared.


RESULTS
There were no statistically significant differences between the inpatient and outpatient groups for visual acuity. Excluding patients with pre-existing nonlenticular ocular disease, a best-corrected visual acuity of 20/40 or better was achieved in 93.1% of inpatient cases and in 97.2% of outpatient cases 6 months after surgery. Postoperative, clinically apparent cystoid macular edema was more common in the inpatient group (P = 0.03); however, after exclusion of patients with diabetes, hypertension, age younger than 65 years, and eyes with pre-existing nonlenticular disease, there was no statistically significant difference between groups. No significant differences in rates for other operative and postoperative complications were identified, including wound dehiscence, unplanned postoperative filtering blebs, infectious endophthalmitis, retinal detachment, persistent iridocyclitis, glaucoma, and corneal edema.


CONCLUSIONS
This study does not demonstrate that the transition to outpatient cataract extractions has had an adverse effect on surgical outcomes.
Holland
G N
GN
Jules Stein Eye Institute, Los Angeles, CA 90024-7003.
Earl
D T
DT
Wheeler
N C
NC
Straatsma
B R
BR
Pettit
T H
TH
Hepler
R S
RS
Christensen
R E
RE
Oye
R K
RK
D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D002387:Cataract Extraction; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007431:Intraoperative Complications; D007910:Lenses, Intraocular; D008297:Male; D011183:Postoperative Complications; D016896:Treatment Outcome; D014792:Visual Acuity