OPEN LACRIMAL SURGERY - A COMPARISON OF ADMISSION OUTCOME AND COMPLICATIONS AFTER PLANNED DAY-CASE OR INPATIENT MANAGEMENT

Aims-To assess the outcome, in terms of completion of admission and co mplication rates, for two series of patients undergoing open lacrimal surgery, one group planned for a day case admission and the other plan ned for inpatient stay. Methods-A retrospective analysis of case notes was performed for 200 patients planned to have day case admission (fo r 209 open lacrimal operations) and the details compared with those fo r 200 inpatient admissions (for 228 lacrimal procedures) during the sa me period of study The success rates for surgery were not examined. Re sults-9% of planned dau cases required overnight admission, 5.5% for m edical reasons and 3.5% for social or administrative reasons. There wa s a similar incidence of postoperative complications in planned day ca ses and inpatients, although 6% of day case patients developed postope rative cellulitis, compared with 1.3% of the inpatients (p = 0.01). Ov erall, the incidence of cellulitis was greater in cases complicated by intraoperative haemorrhage (p < 0.05) or the use of absorbable nasal packing (p < 0.0001). A similar number of patients in each group atten ded the accident and emergency department before the planned first pos toperative clinic visit. Conclusion-Patients undergoing open lacrimal surgery can be safely managed as day cases if carefully selected for s uitability on social and medical criteria. The use of general anaesthe sia is not, in itself, a contraindication to day case lacrimal surgery .