New research suggests it is safe to perform cataract surgery using topical anesthesia and intravenous sedation without requiring patients to fast prior to surgery.
Fasting before cataract surgery is a long-standing precautionary practice. Doing so allows the stomach to empty prior to surgery, reducing the risk of the patient aspirating contents of their stomach into their lungs when medications are given that may reduce the body’s normal protective mechanisms.
Aspiration of stomach contents during surgery can cause aspiration pneumonia, a potentially serious cataract surgery complication.
But there also are risks associated with fasting, particularly for people with diabetes.
Canadian researchers at the Department of Ophthalmology and Visual Sciences, University of British Columbia and the Department of Anesthesia, Providence Health Care (Vancouver, B.C.) performed a retrospective study of more than 5,000 cases of cataract surgery performed at Mount St. Joseph Hospital (Vancouver) between April 2007 and March 2008.
Nearly all of the cataract removal procedures (97 percent) were performed using only topical anesthesia. A small minority (3 percent) required additional anesthesia injected behind or around the eye to prevent eye movements during surgery.
Approximately 50 percent of patients received intravenous (IV) sedation for the cataract procedure, as deemed appropriate by the attending medical staff.
All patients in the study were allowed to eat and drink freely until they arrived at the hospital, approximately one hour prior to their cataract removal.
Results of the study, published in this month’s issue of Canadian Journal of Ophthalmology, indicate that there were no cases of aspiration pneumonia among the 5,125 non-fasting cataract surgery patients in the study.
The authors concluded that it is safe to perform cataract surgery under topical anesthesia and intravenous sedation without requiring patients to fast prior to surgery.