Association of postoperative delirium with visual acuity after ophthalmic surgeries under local anesthesia

To investigate the incidence rate and risk factors for postoperative delirium (POD) following ophthalmic surgery under local anesthesia.

A retrospective study METHODS: We retrospectively investigated the incidence rate of POD in 4658 patients who underwent vitrectomy or glaucoma surgery between January 2009 to March 2023 and analyzed the risk factors with multivariate logistic regression compared to non-delirium patients. Risk indices included age, sex, operation time, preoperative best-corrected visual acuity (pre-BCVA), comorbidity of dementia, and the use of sedative or hypnotic drugs.

POD developed in 19 out of 4658 patients (0.41%). POD was more prevalent in older patients and those with dementia (P < 0.001 and P < 0.001, respectively). However, sex, longer operation time, the use of sedative or hypnotic drugs were not associated with POD. The low pre-BCVA in either operated eye or fellow eye was more likely observed in patients with POD (P = 0.003 and P = 0.001, respectively). The multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.00-1.12; P = 0.04), dementia (OR, 34.95; 95% CI, 12.32-99.15; P < 0.001), pre-BCVA in the operated eye (OR, 2.00; 95% CI, 1.13-3.53; P = 0.02) and pre-BCVA in the fellow eye (OR, 1.83; 95% CI, 1.16-2.89; P = 0.01) were significantly associated with developing POD.

POD developed following ophthalmic surgery under local anesthesia. Identified risk factors included older age, comorbid dementia and low pre-BCVA.