Boone W B, Seymore C
J Natl Med Assoc. 1984 Dec;76(12):1201-4.
Outpatient ophthalmic surgery has arrived, and ambulatory surgical centers are cropping up all across the country. Government and third-party payers have produced significant financial incentives for performing outpatient surgery, but there are, perhaps, more compelling reasons for allowing this option for patients. Advantages accrue to both the patient and the ophthalmic surgeon. Disadvantages can be minimized and the prospects for success can be maximized through proper preoperative workup, anesthesia management, and postoperative follow-up.In the experience of one of the authors with outpatient cataract and intraocular lens surgery, 66.7 percent of outpatients achieved visual acuity of 20/40 or better and 33.3 percent of inpatients achieved visual acuity of 20/40 or better. All patients had significant improvement in vision, and failure to achieve a 20/40 level of vision was caused by preoperative pathology. Because of these considerations, the authors believe that it is not only reasonable but prudent to direct the development of skills and techniques toward even safer and more efficient outpatient ophthalmic surgery.
门诊眼科手术已然兴起,流动手术中心在全国各地如雨后春笋般涌现。政府和第三方支付机构为开展门诊手术提供了可观的经济激励措施,但或许还有更具说服力的理由让患者选择这种手术方式。患者和眼科外科医生都能从中受益。通过适当的术前检查、麻醉管理及术后随访,可将不利因素降至最低,并使手术成功的可能性最大化。以其中一位作者在门诊白内障及人工晶状体手术方面的经验为例,66.7%的门诊患者视力达到或优于20/40,而住院患者中这一比例为33.3%。所有患者的视力均有显著改善,未能达到20/40视力水平是由术前病变所致。基于这些考虑,作者认为不仅要合理,而且要审慎地发展相关技能和技术,以实现更安全、更高效的门诊眼科手术。