Anesthesia techniques and the risk of complications as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery.

Autor:	Segers MHM; From the University Eye Clinic, Maastricht University Medical Center+, Maastricht, the Netherlands (Segers, van den Biggelaar, Nuijts, Dickman); Department of Ophthalmology, Oxford Eye Hospital, Oxford, United Kingdom (Rosen); European Society of Cataract and Refractive Surgeons (ESCRS), Dublin, Ireland (Brocato); Department of Ophthalmology, Amsterdam UMC, Amsterdam, the Netherlands (Henry); Department of Ophthalmology, Antwerp University Hospital, Antwerp, Belgium (Tassignon); Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom (Young); Department of Ophthalmology, Sahgrenska University Hospital, Mölndal, Sweden (Stenevi); Department of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden (Behndig); Department of Clinical Sciences, Ophthalmology, Lund University, Lund, Sweden (Lundström)., Rosen P, van den Biggelaar FJHM, Brocato L, Henry YP, Nuijts RMMA, Tassignon MJ, Young D, Stenevi U, Behndig A, Lundström M, Dickman MM
Jazyk:	angličtina
Zdroj:	Journal of cataract and refractive surgery [J Cataract Refract Surg] 2022 Dec 01; Vol. 48 (12), pp. 1403-1407. Date of Electronic Publication: 2022 Jul 08.
DOI:	10.1097/j.jcrs.0000000000001009
Abstrakt:	Purpose: To determine the trends in anesthesia techniques for cataract surgery over the past decade and their relationship to surgical complications. Setting: Clinics affiliated with the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). Design: Retrospective cross-sectional register-based study. Methods: Variables include patient demographics, visual acuity, ocular comorbidities, surgery characteristics, intraoperative complications, and postoperative complications for the study period from January 2008, to December 2018. The anesthesia methods registered in the EUREQUO and included in the study are topical, combined topical and intracameral, sub-Tenon, regional, and general anesthesia. Multivariate logistic regression models for each complication were constructed to estimate the adjusted odds ratio (OR) and 95% CIs. Results: Complete data were available of 1 354 036 cataract surgeries. Topical anesthesia increased significantly over time (from 30% to 76%, P < .001). Sub-Tenon and regional anesthesia decreased (from 27% and 38% to 16% and 6%, respectively, P < .001), and general and combined topical and intracameral anesthesia remained stable (around 2%). Sub-Tenon (OR, 0.80; 95% CI, 0.71-0.91, P < .001), regional (0.74; 95% CI, 0.71-0.78, P < .001), general (0.53; 95% CI, 0.50-0.56, P < .001), and intracameral anesthesia (0.76; 95% CI, 0.64-0.90, P = .001) carried a significantly decreased risk of posterior capsule rupture (PCR), with and without dropped nucleus, compared with topical anesthesia. The risk of endophthalmitis was significantly lower with regional anesthesia compared with topical anesthesia (OR, 0.60; 95% CI, 0.44-0.82, P = .001). Conclusions: The use of topical anesthesia for cataract surgery increased over time. Topical anesthesia is associated with an increased risk of PCR with and without dropped nucleus, and endophthalmitis. (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of ASCRS and ESCRS.)
Databáze:	MEDLINE
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