Cataract extraction in a major ophthalmic hospital: Day-case or overnight stay?

Purpose: Cataract surgery is increasing in Australia and represents a signi ficant burden on limited health resources. This study examines the frequenc y and outcomes of cataract surgery for patients who were hospitalized overn ight compared with those treated as day surgery cases. Methods: Medical records of 671 consecutive admissions for cataract surgery at the Royal Victorian Eye and Ear Hospital were reviewed. Data analysed i ncluded demographic features, insurance status, length of hospitalization, ophthalmic conditions, medical conditions, social problems and planned surg ical technique. Ophthalmic and anaesthetic complications, active ophthalmic and medical interventions were also studied. Results: Of the 671 patient admissions for cataract during the study period , 226 (33.4%) were hospitalized overnight. Factors significantly associated with overnight hospitalization in univariate analyses include older age, f emale sex, country residence, Veterans' Affairs insurance, monocular vision status, pre-existing ischaemic heart disease, pre-existing asthma/chronic obstructive lung disease, absence of carer, transportation problems, planne d extra-capsular cataract extraction technique, ophthalmic complications an d active ophthalmic and/or medical interventions. After adjusting for possi ble confounding factors using backwards stepwise multivariate logistic regr ession models all except pre-existing ischaemic heart disease and opthalmic complications were significantly associated with overnight admission for c ataract surgery. In total, 14 cases (2.1%) needed active ophthalmic and/or medical interventions, 13 overnight cases and one day case. Conclusions: These data suggest that many patients who are hospitalized ove rnight for cataract surgery could be safely treated as day cases. Such a sh ift in the pattern of care for cataract surgery could provide a significant potential for health care savings.