Preoperative Medication Disclosure Failure Leads to Postoperative Complications

Case Overview

This case study involves an adult patient who underwent a series of ophthalmologic procedures, including phacoemulsification, canaloplasty, and goniotomy. Subsequent to these surgeries, the patient experienced elevated intraocular pressure (IOP) and severe discomfort.

It was later discovered that the performing physician was not informed about the patient's ongoing Plavix medication during the time of the surgeries. This raises questions regarding the standard of care provided and whether incomplete medical history disclosure could have contributed to postoperative complications.

Questions to the Ophthalmology expert and their responses

How frequently do you perform ophthalmologic procedures such as phacoemulsification, canaloplasty, and goniotomy?

As a comprehensive ophthalmologist, I handle 8-15 eye surgery cases in the operating room every week. These include a mixture of cataract surgery, glaucoma, cornea, and oculoplastics cases.

What are the most pertinent measures that physicians can take to minimize the incidence of elevated intraocular pressure in patients undergoing ophthalmologic procedures like phacoemulsification, canaloplasty, and goniotomy?

The procedures mentioned—canaloplasty and goniotomy—are typically performed when intraocular pressures are already elevated. However, several factors can contribute to raised IOP following cataract and other surgeries. These include failure to adequately remove surgical viscoelastic material, retained lens material, and steroid-response.

Have you ever reviewed a similar case? If yes, please elaborate.

I have reviewed similar cases involving postoperative complications after ophthalmologic procedures. However, each case is unique and requires a thorough review of the medical records.

About the expert

This expert is a seasoned ophthalmologist with over two decades of experience in the field. They hold an impressive academic background, including an MD from a prestigious Ivy League institution and board certification in ophthalmology. Their extensive involvement in academia, professional organizations, and leadership roles in comprehensive ophthalmology at renowned medical centers, coupled with their current position at a major VA medical center, underscores their expertise and relevance to this case study.