National Survey of Day-Case Vitreoretinal Surgery in the United Kingdom

Abstract

Day-case surgery has become uniformly accepted in ophthalmology for most procedures but not for complex, lengthy ones, including vitreoretinal surgery. There is a need for uniform practice that is not only financially and resource efficient, but also convenient for patients. To describe current practice patterns of day-case vitreoretinal (DCVR) surgery in the United Kingdom. A 16-part e-mail questionnaire was sent to UK vitreoretinal consultants, with day-case surgery defined as patients admitted and discharged following surgery on the same day. The questionnaire was sent to all consultant members of the Britain and Eire Association of Vitreoretinal Surgeons using the e-mail address beavrs@yahoogroups.com to increase the response rate. The overall response rate was 41%. Of 55 responders, 9% do not undertake DCVR surgery, but 61% perform DCVR surgery in >75% of patients. Of all undertaking DCVR surgery, 85% of responders discharge patients home and 13% to a hostel. A total of 76% of responders use local/sub-Tenon anesthesia in >50% of patients undergoing DCVR surgery. A total of 15% of responders were not in favor of DCVR surgery. Common reasons for not undertaking DCVR surgery were significant traveling distances for patients, patient choice, and the need for support during posturing. The practice of DCVR surgery across the United Kingdom is variable and is influenced by local factors, patient factors, and surgeon views. There is a lack of guidelines to help decision-making. Common standards are required to maximize clinical outcomes and patient satisfaction, as well as reduce the cost burden of hospital admissions.