Elder J R
Prince of Wales Hospital, Sydney, Australia.
Aust N Z J Ophthalmol. 1987 Nov;15(4):325-8. doi: 10.1111/j.1442-9071.1987.tb00091.x.
Office-based intraocular surgery has been carried out for three years and over 1400 procedures have been performed. There have been no systemic complications or infections. The establishment of an office-based facility is a complex venture. Apart from medicolegal, ethical and financial considerations there are regulations relating to structural requirements, sterilisation of instruments, air-conditioning, electrical hazards and other technical matters. Office-based surgery is convenient for both the patient and the surgeon. The patient remains calm and relaxed from the time of initial counselling to the end of postoperative convalescence. We have borrowed systems used in the United States for management of ambulatory surgical patients, in particular the counselling techniques. This, in our opinion, has been a significant factor for calm relaxed surgery. Patient acceptance and preference for ambulatory surgery will ensure that it is here to stay. A case can be made out for an economic and ethical obligation for this form of surgery to be implemented on a more widespread basis. It is not, however, the universal solution to ocular surgery. There are still specific indications and contraindications, in terms of both the doctor and the patient. At a time when government involvement is being felt more and more in the practice of medicine, any proven alternative method of health care delivery, provided entirely by the private sector, must be worthy of serious consideration.
门诊眼科手术已开展三年，实施了1400多例手术。未出现全身并发症或感染情况。建立门诊手术设施是一项复杂的工作。除了法医学、伦理和财务方面的考虑因素外，还有关于结构要求、器械消毒、空调、电气安全及其他技术问题的规定。门诊手术对患者和外科医生都很方便。从最初咨询到术后康复结束，患者都能保持平静和放松。我们借鉴了美国用于管理门诊手术患者的系统，特别是咨询技巧。我们认为，这是实现平静、轻松手术的一个重要因素。患者对门诊手术的接受度和偏好将确保其持续存在。可以提出理由说明有经济和伦理义务更广泛地实施这种手术形式。然而，它并非眼科手术的通用解决方案。在医生和患者方面仍有特定的适应症和禁忌症。在医疗实践中越来越能感受到政府干预的时候，任何完全由私营部门提供的经证实的替代医疗服务方式都必须值得认真考虑。
