Oral Sedation in Glaucoma Surgery

Tips for incorporation into your practice.

Zachary Vest, MD

Glaucoma Today

Key Takeaways Oral anesthesia has a growing role in some ophthalmic surgeries. The use of oral sedation in glaucoma surgery can simplify pre- and postoperative procedures, benefitting the patient, the surgeon, and OR workflows. Knowing yourself as a surgeon, understanding which patients are good candidates, and engaging your staff are key to incorporating oral sedation into practice. Oral sedation has long been used in oculoplastic surgery and is becoming more common in other ophthalmic subspecialties. The role of oral sedation in cataract surgery has been well documented in ambulatory surgery centers (ASCs) and increasingly in office-based surgical suites.1,2 An oral approach to anesthesia is becoming more frequent in retina, glaucoma, and corneal surgeries as well.3,4 This article outlines the benefits of oral sedation and offers advice on incorporating it into your practice. REASONS FOR ADOPTION in ophthalmic surgery Oral sedation removes the need for fasting. This is a substantial benefit for patients, for whom fasting and the placement of an intravenous (IV) line often cause greater disruption and anxiety than the surgery itself. Moreover, many patients are unsure how to maintain a medical schedule when fasting. As a result, patients with diabetes can experience large swings in blood glucose levels. Glucagon-like peptide-1 receptor agonists and antihypertensive medications are also frequently mismanaged by fasting patients during the preoperative period.5 Adjusting these classes of medication can lead to situations in which the anesthesia provider must deliver temporizing IV medications or surgery must be canceled.

Presbyopia: The Future Is Here

New treatment options are helping us meet patient needs better than ever before.

Neena James, OD

Modern Optometry

Presbyopia is universal; if we live long enough, we will all experience it. Researchers reported that 1.8 billion people were presbyopic in 2015 and that, by 2030, this number will reach 2.1 billion.1 The need for more treatment options is vast, and innovation in this field is welcome. Growth is the name of the game; think of how many patients who rely on readers alone have never had a comprehensive eye examination. That makes presbyopia not only a treatment opportunity but also a gateway to preventative eye care and broader eye health education. To optometrists, presbyopia feels routine. We know there is nothing wrong, and we know it is inevitable. For many patients, however, struggling to see up close is life-changing. It can be scary, frustrating, and often embarrassing, especially in a world that depends on smartphones. Presbyopia has been shown to cause more symptoms and reduce quality of life more than hypertension, glaucoma, and macular degeneration combined.2 Even in its earliest stages, presbyopia can interfere with daily routines. Our role, and the role of our staff, is not only to offer solutions but also to show compassion and help patients feel understood and seen (pun intended).

Breaking News from the ASCRS Meeting in Washington DC

Eyetube

Eyewire reports on new products and breaking news live from the American Society of Cataract and Refractive Surgery meeting in Washington DC.  Learn more about your ad choices. Visit megaphone.fm/adchoices