Preoperative Evaluation for Ophthalmic Surgery

Evidence-Based Recommendations

The American Family Physician guidelines state that patients in their usual state of health undergoing cataract surgery do not require preoperative testing 1
The American Academy of Ophthalmology's Preferred Practice Pattern notes that three randomized trials failed to show that preoperative medical evaluation reduces systemic or ocular complications 2

The Association of Anaesthetists recommends knowing the hemoglobin concentration before surgery in patients over 75 years as part of their surgical safety checklist 3
Directed testing should be obtained if specific clinical conditions are present, such as known anemia or symptoms suggesting anemia 1, 4, 5
Check renal function (eGFR) if the patient has known kidney disease or is on medications requiring renal dose adjustment 3
Check glucose if the patient has known diabetes requiring perioperative management adjustment or is at very high risk of undiagnosed diabetes 1

For elderly patients undergoing major surgery with general anesthesia, the Association of Anaesthetists recommends more comprehensive preoperative assessment including hemoglobin and renal function 3
Pre-operative anemia in elderly surgical patients is associated with myocardial ischemia, falls, and poor wound healing 4, 5, 6