Usually after vitreoretinal surgery most patients are forced to stay in hospital or to maintain a specific head position. This could be useful for a fast reattachment of the retina or to avoid recurrences?
Dear Vingolo,
If you are sure that patient can be accordance with requested position and recommendations, you needn't make the patient stay in hospital.
Kind Regards
In my esperienze position and bed stay are similar at home or in hospital so there is less risk at home than in hospital
All my vitreoretinal surgery has been done without an assistant under local anesthesia as an outpatient (patient goes home directly after surgery) for over 20 years. There is no need for hospitalization except in very rare cases, usually having more to do with the patient (such as a child) than the surgery itself.
Our brief experience only two year treating retinal detachment as outpatient confirm your view, our exception is only for patients with severe diseases like parkinson or alzehimer or heart failure
For 15 years I performed vitreoretinal surgery under local anesthesia (95% of patients) as outpatient procedures at Clinica Oftalmologica Centro Caracas in Venezuela. There is no need for hospitalization for very high success. During the last 3 years I have experience with patients that are hospitalized in my new facility at King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia due to institution’s policies. There is no difference in success rate. Hospitalization does not help in terms of fast reattachment of the retina or to avoid recurrences.
I really agree to your thought even in italy most of the ophthalmologists think the opposite.
Daycase vitreoretinal surgery is the norm for our cases at the Birmingham and Midland Eye Centre. It is especially appropriate using local anaesthesia and a 23 gauge system. The results are not affected, patients can have the first day check at their local hospitals, or with us. The chances of acquired infection are much less and the cost to the Health Service are is also reduced. I would recommend it as it is very popular with the patients.
Certainly hospitalization after VRS might be limited to some of the cases in whom the general anesthesia is compulsory, with intraoperative complications such as choroidals,. Traditionaly, however, hospitalization in the early postop 1-day period is favoured due mostly to medicolegal concerns.
I give immediate prone position to patient for 4 hrs and then discharge. Very few patients require admissions that to not because of sx but pt physical condition