Assessing predictive value of testing

Article

According to this article, not all patients may benefit from routine testing prior to surgery. A better option may be selective screening for those at greatest risk for adverse systemic events.

However, routine testing may not benefit all patients. In some cases, a better option may be selective screening for those who are at the greatest risk for adverse systemic events.

"We believe that our results demonstrate that routine preoperative testing does not measurably improve the safety of vitreoretinal surgery, and that reduction of such testing may considerably reduce healthcare costs," said study author Dr Ajay Shalwala, Wills Eye Institute, Philadelphia, Pennsylvania, USA.

"Our results also suggest that patients with coronary artery disease, asthma and chronic renal disease and those undergoing general anaesthesia are at greater risk of postoperative systemic complications," he said. "Therefore presence of these risk factors should alert physicians to the need for greater preoperative and postoperative monitoring.

"Conversely, the absence of these risk factors may allow physicians to reduce the burden and cost of preoperative testing," Dr Shalwala added.

As with other types of procedures, screening medical tests are routinely performed on patients in preparation for vitreoretinal surgery.

However, the benefit of routine testing is uncertain.

Routine preoperative medical testing prior to elective surgery has been questioned. Some data suggest that there are no significant differences in the rates of either intraoperative and postoperative events between patients who did or did not undergo the standard battery of preoperative testing.

In addition, preoperative testing is expensive and adds to the overall economic healthcare burden.

About the study

In this study, Dr Shalwala and colleagues assessed the predictive value of routine medical testing for postoperative systemic adverse events among patients who were undergoing vitreoretinal surgery.

In a retrospective single centre study, the researchers evaluated the medical charts of 2296 patients who were 17 years of age and older and who underwent vitreoretinal surgery between January 2002 and November 2011 at Vanderbilt University.

The charts for 2215 patients were reviewed for information on baseline comorbidities, preoperative testing and postoperative adverse events that occurred within 30 days of their surgery.

Charts with less than 7 days of documented follow up were excluded from the study.

Logistic regression analysis was performed to correlate adverse events with preoperative testing and comorbidities that were present at baseline.

Within this cohort, 89 patients experienced adverse events and 12 patients had multiple events, for a total of 102 events. Within this subgroup, 73 (72%) of the adverse events occurred within the first 24 hours after surgery, while the remaining 29 (28%) occurred between postoperative days 1 and 30.

Overall, the incidence of adverse events following vitreoretinal surgery in this series was 4%.

Newsletter

Join ophthalmologists across Europe—sign up for exclusive updates and innovations in surgical techniques and clinical care.

Recent Videos
Christine Curcio, PhD, of the University of Alabama at Birmingham Heersink School of Medicine, shares histology update and revised nomenclature for OCT with Sheryl Stevenson of the Eye Care Network and Ophthalmology Times
SriniVas R. Sadda, MD, FARVO, shares key points from his retina presentation at the International SPECTRALIS Symposium
Robert Sergott, MD, describes fluorescence lifetime imaging ophthalmoscopy (FLIO) and the International SPECTRALIS Symposium – And Beyond (ISS) in Heidelberg, Germany.
Anat Loewenstein, MD, describes her presentation on remote imaging for age-related macular degeneration and geographic atrophy at the International SPECTRALIS Symposium, in conversation with Hattie Hayes of Ophthalmology Times Europe
Tyson Brunstetter, OD, PhD, a US Navy Aerospace Optometrist at the NASA Johnson Space Center in Houston, Texas, shares key takeaways from his keynote at the International SPECTRALIS Symposium (ISS)
Viha Vig, MBChB graduate student at the University of Auckland, New Zealand, discusses her poster presentation on the relationship between mitochondiral disease, Alzheimer disease, and other types of dementia.
Alfredo Sadun, MD, PhD, chief of Ophthalmology at the Doheny Eye Institute, University of California Los Angeles, shared exciting new research with the Eye Care Network during the Association for Research in Vision and Ophthalmology (ARVO) meeting on the subject of Leber hereditary optic neuropathy (LHON).
At this year's Association for Research in Vision and Ophthalmology (ARVO) meeting in Salt Lake City, Utah, Nitish Mehta, MD, shared highlights from his research documenting real-world results of aflibercept 8 mg for patients with diabetic macular oedema.
ARVO 2025: Anat Loewenstein, MD, shares data from herself and her colleagues on meeting needs of patients with diabetic retinopathy
A photo of Seville, Spain, with the Congress on Controversies in Ophthalmology logo superimposed on it. Image credit: ©francovolpato – stock.adobe.com; logo courtesy COPHy
© 2025 MJH Life Sciences

All rights reserved.