Open lacrimal surgery: A comparison of admission outcome and complications after planned day case or inpatient management

Abstract

Aims-To assess the outcome, in terms of completion of admission and complication rates, for two series of patients undergoing open lacrimal surgery, one group planned for a day case admission and the other planned for inpatient stay. Methods - A retrospective analysis of case notes was performed for 200 patients planned to have day case admission (for 209 open lacrimal operations) and the details compared with those for 200 inpatient admissions (for 228 lacrimal procedures) during the same period of study. The success rates for surgery were not examined. Results--9% of planned day cases required overnight admission, 5.5% for medical reasons and 3.5% for social or administrative reasons. There was a similar incidence of postoperative complications in planned day cases and inpatients, although 6% of day case patients developed postoperative cellulitis, compared with 1.3% of the inpatients p= 0.01). Overall, the incidence of cellulitis was greater in cases complicated by intraoperative haemorrhage (p < 0.05) or the use of absorbable nasal packing (p< 0.0001). A similar number of patients in each group attended the accident and emergency department before the planned first postoperative clinic visit. Conclusion - Patients undergoing open lacrimal surgery can be safely managed as day cases if carefully selected for suitability on social and medical criteria. The use of general anaesthesia is not, in itself, a contraindication to day case lacrimal surgery.