Structured assessment tool to evaluate patient suitability for cataract surgery under local anaesthesia

Cataract extraction and intraocular lens implantation is a common surgical procedure. While the vast majority of these operations are performed under local anaesthesia (LA), this is not an appropriate technique for every patient. Likewise it is time-consuming to assess all patients fitness for general anaesthesia when most will not need it.

We developed an eight-item questionnaire that can be administered before admission to assess patient suitability for surgery under LA. In a prospective study over a 9-month period, 128 patients were seen in a pre-admission clinic, and according to the responses to the questionnaire administered by junior medical staff, 123 were deemed suitable for surgery under LA, and five under general anaesthetic (GA).

All 123 patients went on to have surgery successfully performed under LA. A further two patients from the GA group were determined by the attending anaesthetist to be suitable for surgery under LA.

This assessment instrument has been shown to be a highly specific means of selecting patients for surgery under LA, and can be administered by medical or nursing staff.