April 27, 2015 – Cataract Preop


Anchor lead: How much medical testing is needed before cataract surgery? Elizabeth Tracey reports

Cataract surgery is very common, and so is medical testing beforehand, costing taxpayers millions of dollars although a study led by Johns Hopkins ophthalmologist Oliver Schein showed more than a decade ago that it doesn’t improve outcomes in this very safe procedure.  Now a new study in the New England Journal of Medicine supports that conclusion but finds that a lot of preoperative testing continues.  Schein comments.

Schein: I believe all those patients could arrive on the day of surgery and be screened by the anesthesia staff and the nursing staff to see if they were actively ill on the day of surgery. And if so, that small proportion would have their surgeries postponed.  The ones that screened positive with the questionnaire should go and see their physicians.  In order to do what I’m suggesting there has to be regulatory change because there currently is a requirement that there be a history and physical and a history and physical by the anesthesiologist on the day of surgery does not qualify as a preoperative history and physical.  :33

At Johns Hopkins, I’m Elizabeth Tracey.