Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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are between -4 and -8 diopters. I believe it's best to have a retina surgeon examine these high-risk patients before surgery and at 1 month post-op to ensure no retinal-related issues arise, and that any tears are treated before detachments occur. Clinical considerations A vast majority of same-day bilateral cataract surgery patients do as well as if not better than patients who undergo procedures on sepa- rate days, because it's physically easier on patients with several comorbidities to do both eyes at once. The primary exclusions of the past — patients with severe corneal issues or uncontrolled glaucoma — are not as worrisome today, thanks to improvements in cataract surgery technology and practice enhancements. There's little clinical difference in the vast majority of patients, excluding borderline failing Fuchs' dystrophy and diabetics with significant retinopathy, in per- forming procedures back to back, but it does require extra attention to these details: • Separate supplies. All patients must receive intracameral antibi- otics and both surgeries must be treated as distinct procedures. Nurses must ensure that all supplies, instruments and lenses intended for each eye are kept separate in the OR. When one case is finished, they must discard the supplies and start setting up for the second eye as if it's a completely new procedure on a different patient. Whenever possible, buy 2 sets of supplies from different manufacturers, so your surgical team can tell right and left devices apart. That's especially true for vis- coelastic products, which are complex molecules that possess the highest bioburden standard of acceptance of anything we use in the OR. If you can't buy viscoelastics from different manufacturers, try to purchase products with different lot numbers, so the surgical team can easily tell them apart. 9 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 6