Evaluation of patient comfort with outpatient orbital surgery.
ABSTRACT To evaluate patient comfort with outpatient orbital surgery.
Prospective, non-randomized study.
The experience of 34 consecutive outpatient orbital procedures in 30 patients was evaluated. The data obtained included subjective postoperative pain and discomfort at 3 time intervals (immediate, postoperative day 1 and 1 week) using a 100 mm visual analogue scale (VAS). Patients were also asked to rate the overall experience after one week of follow-up.
The average pain and discomfort scores in the immediate postoperative period measured 13.95 and 12.61, respectively. Overnight scores of 5.91 and 7.25 were determined for pain and discomfort, and at the one-week follow-up these were 0.91 and 3.42, respectively. All 30 patients reported that they were "satisfied with their overall experience." The highest VAS score for pain at any time was 50. The highest VAS score for discomfort at any time was also 50. All 30 patients had recovered or improved their visual acuity at week one. There was no incidence of retrobulbar hemorrhage, significant loss of vision (greater than two lines), increased intraocular pressure or pupillary defects in any of the patients. None of the study patients required re-hospitalization.
This study suggests that outpatient orbital surgery, in the hands of an experienced orbital surgeon, is safe and well tolerated by the patients regardless of the type of anesthesia or type of procedure.
Ophthalmic plastic and reconstructive surgery 05/2014; 30(4). DOI:10.1097/IOP.0000000000000070 · 0.91 Impact Factor
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ABSTRACT: Background: Orbital blowout fractures can be managed by several surgical specialties including plastic and maxillofacial surgery, otolaryngology, and ophthalmology. Recommendations for surgical fracture repair depend on a combination of clinical and imaging studies to evaluate muscle/nerve entrapment and periorbital tissue herniation. Methods: The aim of this study was to verify the applicability of regional anesthesia when repairing orbital floor fractures. A retrospective chart review was performed for isolated orbital floor fractures treated at the Department of Maxillofacial Surgery in Florence between May 2011 and July 2012. The study included 135 patients who met the inclusion criteria: 96 subjects were male (71%) and 39 were female (29%). The mean age was 45.3 years, ranging from 16 to 77 years. Results: The results revealed that isolated anterior orbital floor fractures can be safely repaired under regional and local anesthesia. Regional and local anesthesia should be combined with intravenous sedation when the fracture involves the posterior floor. The surgical outcome was comparable to the outcome achieved under general anesthesia. There was a lower rate of surgical revisions due to concealed malposition or entrapment of the inferior rectus muscle (19% vs 22%). However, this result was not statistically significant (P > 0.05). Conclusions: There are several advantages to surgically repairing isolated orbital floor fractures under regional and local anesthesia that include the following: surgeons can check the surgical outcome (enophthalmos and extrinsic ocular muscles function) intraoperatively, thereby reducing the reoperation rate; patient discomfort due to general anesthesia is eliminated; and the hospital stay is reduced, thus decreasing overall healthcare costs.01/2014; 2(1):e97. DOI:10.1097/GOX.0000000000000039
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ABSTRACT: Introduction The aim of this study was to evaluate the impact of the 11th version of the National Health System's Activity-Based Financing on the income of a University Hospital department for palpebral, lacrimal, and orbital surgeries. Patients and methods The number of such surgeries in 2008 was based on the Medicalization Program of the Information System. Using the 11th version of the Activity-Based Financing for Diagnosis-Related Groups, we compared the income in both inpatient and outpatient settings. Results Two hundred and forty-eight patients undergoing palpebral, lacrimal, or orbital surgery between January and December 2008 were included, with 87% treated on an outpatient basis. The lower reimbursement for outpatient surgery resulted in a loss of 184,500 euros (79%) for our department compared to the inpatient procedure. Discussion With rigorous organization, ambulatory surgery is feasible for palpebral, lacrimal, and orbital surgery. Nonetheless, with department incomes related to activity, ambulatory care seems financially disadvantageous. Many departments are trying to develop an ambulatory structure, but the need to balance their budget requires improved coherence.Journal francais d'ophtalmologie 05/2010; 33(5):312–318. DOI:10.1016/j.jfo.2010.03.008 · 0.36 Impact Factor