title: American Society of Anesthesiologists classification in cataract surgery: Results from the Ophthalmic Surgery Outcomes Data Project.
abstract: To explore the association of American Society of Anesthesiologists (ASA) classification with cataract surgery outcomes.
  
  
  
  Five Veterans Affairs Medical Centers, United States.
  
  
  
  Retrospective observational cohort study.
  
  
  
  The study analyzed the outcomes of cataract surgery cases. Corrected distance visual acuity (CDVA), unanticipated events, and vision-related quality of life (VRQL) were assessed using the National Eye Institute Visual Function Questionnaire (NEI-VFQ), comparing ASA classes I through IV. For some analyses, ASA classes I and II were designated as Group A and ASA classes III and IV were designated Group B.
  
  
  
  Of the 4923 cases, 875 (17.8%) were in Group A, 4032 (81.9%) were in Group B, and 16 (0.3%) had missing data. The mean CDVA and mean composite NEI-VFQ score improved after cataract surgery in both groups (P < .0001); however, Group A had a better mean postoperative CDVA and postoperative VFQ composite scores than Group B (P < .0001, both outcomes). A higher ASA class was associated with an increased risk for 2 unanticipated events; that is, clinically significant macular edema (CSME) (Group A: 4 [0.47%] versus Group B: 50 [1.28%]; adjusted odds ratio [OR], 3.02; 95% confidence interval [CI], 1.02-13.05; P = 0.04) and readmission to the hospital within 30 days (2 [0.23%] versus 56 [1.41%]; OR, 8.26; 95% CI, 1.71-148.62; P = .004) CONCLUSIONS: Among United States veterans, the ASA classification could be an important predictor of VRQL and visual outcomes. In this cohort, it was associated with an increased risk for 2 serious unanticipated events-CSME and readmission to the hospital-both costly, unwanted outcomes.
  
  
  
  Dr. Vollman is a consultant to Forsight Vision5. None of the authors has a financial or proprietary interest in any material or method mentioned.
authors: From the Ophthalmology Department (Payal, Sola-Del Valle, Gonzalez-Gonzalez, Cakiner-Egilmez, Daly), Veterans Affairs Boston Healthcare System, Jamaica Plain, Department of Ophthalmology (Daly), Boston University School of Medicine, and Department of Ophthalmology (Sola-Del Valle), Harvard Medical School (Payal, Daly), Boston, Massachusetts; Veteran Affairs Tennessee Valley Healthcare System Center (Chomsky) and Vanderbilt Eye Institute (Chomsky), Vanderbilt University Medical, Nashville, Tennessee; the Ophthalmology Department (Vollman), St. Louis Veteran Affairs Medical Center, and Department of Ophthalmology and Visual Sciences (Vollman), Washington University School of Medicine, St. Louis, Missouri; Michael E. DeBakey Veteran Affairs Medical Center (Baze) and Cullen Eye Institute (Baze), Baylor College of Medicine, Houston, Texas; and the Department of Defense/Veterans Affairs Vision Center of Excellence (Lawrence), Bethesda, Maryland, USA.
authors: Abhishek R
authors: AR
authors: Payal
authors: From the Ophthalmology Department (Payal, Sola-Del Valle, Gonzalez-Gonzalez, Cakiner-Egilmez, Daly), Veterans Affairs Boston Healthcare System, Jamaica Plain, Department of Ophthalmology (Daly), Boston University School of Medicine, and Department of Ophthalmology (Sola-Del Valle), Harvard Medical School (Payal, Daly), Boston, Massachusetts; Veteran Affairs Tennessee Valley Healthcare System Center (Chomsky) and Vanderbilt Eye Institute (Chomsky), Vanderbilt University Medical, Nashville, Tennessee; the Ophthalmology Department (Vollman), St. Louis Veteran Affairs Medical Center, and Department of Ophthalmology and Visual Sciences (Vollman), Washington University School of Medicine, St. Louis, Missouri; Michael E. DeBakey Veteran Affairs Medical Center (Baze) and Cullen Eye Institute (Baze), Baylor College of Medicine, Houston, Texas; and the Department of Defense/Veterans Affairs Vision Center of Excellence (Lawrence), Bethesda, Maryland, USA.
authors: David
authors: D
authors: Sola-Del Valle
authors: From the Ophthalmology Department (Payal, Sola-Del Valle, Gonzalez-Gonzalez, Cakiner-Egilmez, Daly), Veterans Affairs Boston Healthcare System, Jamaica Plain, Department of Ophthalmology (Daly), Boston University School of Medicine, and Department of Ophthalmology (Sola-Del Valle), Harvard Medical School (Payal, Daly), Boston, Massachusetts; Veteran Affairs Tennessee Valley Healthcare System Center (Chomsky) and Vanderbilt Eye Institute (Chomsky), Vanderbilt University Medical, Nashville, Tennessee; the Ophthalmology Department (Vollman), St. Louis Veteran Affairs Medical Center, and Department of Ophthalmology and Visual Sciences (Vollman), Washington University School of Medicine, St. Louis, Missouri; Michael E. DeBakey Veteran Affairs Medical Center (Baze) and Cullen Eye Institute (Baze), Baylor College of Medicine, Houston, Texas; and the Department of Defense/Veterans Affairs Vision Center of Excellence (Lawrence), Bethesda, Maryland, USA.
authors: Luis A
authors: LA
authors: Gonzalez-Gonzalez
authors: From the Ophthalmology Department (Payal, Sola-Del Valle, Gonzalez-Gonzalez, Cakiner-Egilmez, Daly), Veterans Affairs Boston Healthcare System, Jamaica Plain, Department of Ophthalmology (Daly), Boston University School of Medicine, and Department of Ophthalmology (Sola-Del Valle), Harvard Medical School (Payal, Daly), Boston, Massachusetts; Veteran Affairs Tennessee Valley Healthcare System Center (Chomsky) and Vanderbilt Eye Institute (Chomsky), Vanderbilt University Medical, Nashville, Tennessee; the Ophthalmology Department (Vollman), St. Louis Veteran Affairs Medical Center, and Department of Ophthalmology and Visual Sciences (Vollman), Washington University School of Medicine, St. Louis, Missouri; Michael E. DeBakey Veteran Affairs Medical Center (Baze) and Cullen Eye Institute (Baze), Baylor College of Medicine, Houston, Texas; and the Department of Defense/Veterans Affairs Vision Center of Excellence (Lawrence), Bethesda, Maryland, USA.
authors: Tulay
authors: T
authors: Cakiner-Egilmez
authors: From the Ophthalmology Department (Payal, Sola-Del Valle, Gonzalez-Gonzalez, Cakiner-Egilmez, Daly), Veterans Affairs Boston Healthcare System, Jamaica Plain, Department of Ophthalmology (Daly), Boston University School of Medicine, and Department of Ophthalmology (Sola-Del Valle), Harvard Medical School (Payal, Daly), Boston, Massachusetts; Veteran Affairs Tennessee Valley Healthcare System Center (Chomsky) and Vanderbilt Eye Institute (Chomsky), Vanderbilt University Medical, Nashville, Tennessee; the Ophthalmology Department (Vollman), St. Louis Veteran Affairs Medical Center, and Department of Ophthalmology and Visual Sciences (Vollman), Washington University School of Medicine, St. Louis, Missouri; Michael E. DeBakey Veteran Affairs Medical Center (Baze) and Cullen Eye Institute (Baze), Baylor College of Medicine, Houston, Texas; and the Department of Defense/Veterans Affairs Vision Center of Excellence (Lawrence), Bethesda, Maryland, USA.
authors: Amy S
authors: AS
authors: Chomsky
authors: From the Ophthalmology Department (Payal, Sola-Del Valle, Gonzalez-Gonzalez, Cakiner-Egilmez, Daly), Veterans Affairs Boston Healthcare System, Jamaica Plain, Department of Ophthalmology (Daly), Boston University School of Medicine, and Department of Ophthalmology (Sola-Del Valle), Harvard Medical School (Payal, Daly), Boston, Massachusetts; Veteran Affairs Tennessee Valley Healthcare System Center (Chomsky) and Vanderbilt Eye Institute (Chomsky), Vanderbilt University Medical, Nashville, Tennessee; the Ophthalmology Department (Vollman), St. Louis Veteran Affairs Medical Center, and Department of Ophthalmology and Visual Sciences (Vollman), Washington University School of Medicine, St. Louis, Missouri; Michael E. DeBakey Veteran Affairs Medical Center (Baze) and Cullen Eye Institute (Baze), Baylor College of Medicine, Houston, Texas; and the Department of Defense/Veterans Affairs Vision Center of Excellence (Lawrence), Bethesda, Maryland, USA.
authors: David E
authors: DE
authors: Vollman
authors: From the Ophthalmology Department (Payal, Sola-Del Valle, Gonzalez-Gonzalez, Cakiner-Egilmez, Daly), Veterans Affairs Boston Healthcare System, Jamaica Plain, Department of Ophthalmology (Daly), Boston University School of Medicine, and Department of Ophthalmology (Sola-Del Valle), Harvard Medical School (Payal, Daly), Boston, Massachusetts; Veteran Affairs Tennessee Valley Healthcare System Center (Chomsky) and Vanderbilt Eye Institute (Chomsky), Vanderbilt University Medical, Nashville, Tennessee; the Ophthalmology Department (Vollman), St. Louis Veteran Affairs Medical Center, and Department of Ophthalmology and Visual Sciences (Vollman), Washington University School of Medicine, St. Louis, Missouri; Michael E. DeBakey Veteran Affairs Medical Center (Baze) and Cullen Eye Institute (Baze), Baylor College of Medicine, Houston, Texas; and the Department of Defense/Veterans Affairs Vision Center of Excellence (Lawrence), Bethesda, Maryland, USA.
authors: Elizabeth F
authors: EF
authors: Baze
authors: From the Ophthalmology Department (Payal, Sola-Del Valle, Gonzalez-Gonzalez, Cakiner-Egilmez, Daly), Veterans Affairs Boston Healthcare System, Jamaica Plain, Department of Ophthalmology (Daly), Boston University School of Medicine, and Department of Ophthalmology (Sola-Del Valle), Harvard Medical School (Payal, Daly), Boston, Massachusetts; Veteran Affairs Tennessee Valley Healthcare System Center (Chomsky) and Vanderbilt Eye Institute (Chomsky), Vanderbilt University Medical, Nashville, Tennessee; the Ophthalmology Department (Vollman), St. Louis Veteran Affairs Medical Center, and Department of Ophthalmology and Visual Sciences (Vollman), Washington University School of Medicine, St. Louis, Missouri; Michael E. DeBakey Veteran Affairs Medical Center (Baze) and Cullen Eye Institute (Baze), Baylor College of Medicine, Houston, Texas; and the Department of Defense/Veterans Affairs Vision Center of Excellence (Lawrence), Bethesda, Maryland, USA.
authors: Mary
authors: M
authors: Lawrence
authors: From the Ophthalmology Department (Payal, Sola-Del Valle, Gonzalez-Gonzalez, Cakiner-Egilmez, Daly), Veterans Affairs Boston Healthcare System, Jamaica Plain, Department of Ophthalmology (Daly), Boston University School of Medicine, and Department of Ophthalmology (Sola-Del Valle), Harvard Medical School (Payal, Daly), Boston, Massachusetts; Veteran Affairs Tennessee Valley Healthcare System Center (Chomsky) and Vanderbilt Eye Institute (Chomsky), Vanderbilt University Medical, Nashville, Tennessee; the Ophthalmology Department (Vollman), St. Louis Veteran Affairs Medical Center, and Department of Ophthalmology and Visual Sciences (Vollman), Washington University School of Medicine, St. Louis, Missouri; Michael E. DeBakey Veteran Affairs Medical Center (Baze) and Cullen Eye Institute (Baze), Baylor College of Medicine, Houston, Texas; and the Department of Defense/Veterans Affairs Vision Center of Excellence (Lawrence), Bethesda, Maryland, USA. Electronic address: mary.daly2@va.gov.
authors: Mary K
authors: MK
authors: Daly
mesh_terms: D000072080:Anesthesiologists; D002386:Cataract; D002387:Cataract Extraction; D006801:Humans; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States