Choosing Wisely:

Don’t perform preoperative medical tests for eye surgery unless there are specific medical indications.

Rationale and Comments: For many, preoperative tests are not necessary and add costs because eye surgeries are not lengthy and don’t pose serious risks. An electrocardiogram should be ordered if patients have heart disease. A blood glucose test should be ordered if patients have diabetes. A potassium test should be ordered if patients are on diuretics. In general, patients scheduled for surgery do not need medical tests unless the history or physical examination indicates the need for a test (e.g., like the existence of conditions noted above, heart disease, diabetes, use of diuretics, etc.). Institutional policies should consider these issues.
Sponsoring Organizations:
  • American Academy of Ophthalmology
  • Sources:
  • Cochrane Database of Systematic Reviews
  • Disciplines:
  • Ophthalmologic
  • Surgical
  • References: • Schein OD, et al. The value of routine preoperative medical testing before cataract surgery. N Engl J Med. 2000;342:168-75.
    • Keay L, et al. Routine preoperative medical testing for cataract surgery. Cochrane Database Syst Rev. 2009;(2):CD007293.
    • Bartley GB, et al. Preoperative medical examinations for patients undergoing ophthalmic surgery. Am J Ophthalmol. 1991;112:725-7.
    • Imasogie N, et al. Elimination of routine testing in patients undergoing cataract surgery allows substantial savings in laboratory costs. A brief report. Can J Anesth. 2003;50:246-8.
    • Bass EB, et al. Do ophthalmologists, anesthesiologists and internists agree about preoperative testing in health patients undergoing cataract surgery? Arch Ophthalmol. 1995;113:1248-56.

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