Younger Age and Longer Case Times Associated With Emergency Department Visits After Cataract Surgery

PURPOSE: To characterize the frequency, reasons, hospital costs, and risk factors for emergency de-partment (ED) visits within 30 days of cataract surgery.center dot DESIGN: Retrospective cohort study.center dot METHODS: A retrospective review of all cataract surg-eries at Duke Health between 2013 and 2021 was con-ducted. Demographics, case characteristics (length, com-plexity by billing codes, anesthesia type), ED visit find-ings, and hospital costs were collected. Logistic regression models were used to determine the odds of ED visits based on several risk factors.center dot RESULTS: Of 34 246 patients (57 656 eyes) undergoing cataract surgery at Duke Health from 2013 to 2021, a to-tal of 607 patients (1.77%) had 680 ED visits within 30 days of surgery. The most common ED diagnosis was car-diovascular (24.4%), whereas ocular complaints consti-tuted 15.4% of visits. The most common ocular diagnoses were high intraocular pressure, rebound iritis, and poste-rior vitreous detachment. Hospital costs were lowest for ocular diagnoses (mean $467.72) and highest for trauma diagnoses (mean $4660.55). Risk factors for ED visits included case lengths greater than 30 minutes (OR 2.1, 95% CI 1.56-2.83, P < .001), the combination of Mon-itored Anesthesia Care (MAC) and retrobulbar anesthe-sia or general anesthesia (OR 2.98, 95% CI 1.73-5.12, P < .001), and age less than 70 years (OR 1.39, 95% CI 1.16-1.65, P < .001).center dot CONCLUSIONS: ED visits within 30 days of cataract surgery are uncommon. Longer case lengths, anesthe-sia other than MAC alone, and younger age are associ-ated with higher odds of ED visits. (Am J Ophthal-mol 2023;245: 1-7.(c) 2022 Elsevier Inc. All rights re-served.)