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Related Experiment Video

Updated: Jun 24, 2026

Ultrasound Cyclo Plasty in Eyes with Glaucoma
05:05

Ultrasound Cyclo Plasty in Eyes with Glaucoma

Published on: January 26, 2018

Routine preoperative medical testing for cataract surgery.

Lisa Keay1, Kristina Lindsley, James Tielsch

  • 1Injury Division, George Institute for International Health, P.O. Box M201 Missenden Road, Sydney, NSW, Australia, 2050. lkeay@george.org.au

The Cochrane Database of Systematic Reviews
|April 17, 2009
PubMed
Summary

Routine preoperative medical testing does not improve cataract surgery safety or reduce adverse events. This approach is also more costly, suggesting alternatives like health questionnaires may be more effective for risk assessment.

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Last Updated: Jun 24, 2026

Ultrasound Cyclo Plasty in Eyes with Glaucoma
05:05

Ultrasound Cyclo Plasty in Eyes with Glaucoma

Published on: January 26, 2018

Area of Science:

  • Ophthalmology
  • Evidence-Based Medicine
  • Health Economics

Background:

  • Cataract surgery is a common procedure with increasing rates globally, necessitating optimization of safety and cost-effectiveness.
  • Older patients undergoing cataract surgery often have significant systemic and ocular comorbidities.
  • The utility of routine preoperative medical testing in managing these comorbidities for cataract surgery is questionable.

Purpose of the Study:

  • To evaluate the evidence for reducing adverse events through routine preoperative medical testing before cataract surgery.
  • To estimate the cost associated with routine preoperative medical testing.

Main Methods:

  • Systematic review of randomized clinical trials comparing routine preoperative medical testing versus no or selective testing.
  • Searches conducted across multiple databases (CENTRAL, MEDLINE, EMBASE, LILACS) without date or language restrictions.
  • Independent assessment of abstracts, data extraction, and methodological quality evaluation by two reviewers.

Main Results:

  • Three trials involving 21,531 surgeries found routine testing did not reduce intraoperative or postoperative medical adverse events.
  • Adverse events, primarily cardiovascular, occurred similarly in both pretesting and no-testing groups.
  • Routine testing was estimated to be 2.55 times more expensive, with no difference in surgery cancellations.

Conclusions:

  • Routine preoperative medical testing does not enhance the safety of cataract surgery.
  • Alternatives like self-administered health questionnaires may offer cost-effective risk identification.
  • While routine testing isn't beneficial, managing comorbidities in elderly patients undergoing surgery remains crucial, especially in developing countries where questionnaires may be less effective.