Preoperative Routine Testings versus Selective Routine Testings in the Safty of Cataract Surgery: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

Akram ¹ ,  Arkin ¹ , Juret ¹ , Kadir ² , Minavar ³

1. Department of Eye, The First Hospital, Xinjiang Medical University, Urumqi 830054, China;2. Chinese Evidence-Based Medicine/Cochrane Centre, West China Hospital, Sichuan University, Chengdu 610041, China;3. Department of Clinical, Xinjiang Medical University, Urumqi 830054, China;

Corresponding author：

Arkin, Email: juret.foreye@yahoo.com.cn

Keywords：

Cataract; Routine preoperative testing; Safety; Randomized controlled trial

DOI：

10.7507/1672-2531.20090087

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objectives 　To systematic review the safety of routine preoperative testings versus selective
preoperative testings for cataract surgery.
Methods 　We searched the Cochrane Central Register of Controlled Trials-Central (which contains the Cochrane Eyes and Vision Group Trials Register) in the Cochrane Library (Issue 3, 2008), MEDLINE (1966 to Oct. 2008), EMBASE (1980 to Oct. 2008), CMB-disk (1979 to Oct. 2008). We also hand-searched related journals. All the search was restricted in English and Chinese. Methodological quality of randomized controlled trials (RCTs) was evaluated by simple evaluate method that recommended by the Cochrane Collaboration. Data extracted by two reviewers with designed extraction form. RevMan 5.0 software was used for data management and analysis. Obtained evidence the safety of routine preoperative testings versus selective preoperative testings.
Result　 Four RCTs involving 20 490 participants required cataract surgery were included by total retrieve and riddling. The result of metaanalysis showed that there was no significant difference between the two groups in the rates of intraoperative systemic events [RR=1.05, 95%CI (0.89, 1.24), P=0.59], postoperative systemic events [RR=0.97, 95%CI (0.80, 1.18), P=0.77], intraoperative ocular events [RR=0.99, 95%CI (0.74, 1.33), P=0.97] and postoperative ocular events [RR=1.11, 95%CI (0.76, 1.60), P=0.59].
Conclusion 　To compare routine preoperative testings group with selective preoperative testings group, there was no significant difference in the rates of intraoperative systemic events, postoperative systemic events, intraoperative ocular events and postoperative ocular events. However the application of the results to the patients with incapacitating systemic diseases needs further study.

Citation： Akram,Arkin,Juret,Kadir,Minavar,Abdu,WU TaiXiang,Junire. Preoperative Routine Testings versus Selective Routine Testings in the Safty of Cataract Surgery: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(4): 476-480. doi: 10.7507/1672-2531.20090087 Copy

1.	Davison M, Padroni S. Sub-Tenon’s anaesthesia versus topical anaesthesia for cataract surgery. Cochrane Database of Systematic Reviews, 18 July 2007 in Issue 3, 2007.
2.	Alhassan MB, Kyari F. Peribulbar versus retrobulbar anaesthesia for cataract surgery. Cochrane Database of Systematic Reviews, 16 July 2008 in Issue 3, 2008.
3.	Foster A. Cataract - a global perspective: output, outcome and outlay. Eye, 1999, 13: 449-453.
4.	Fletcher A, Vijaykumar V, Selvaraj S, et al. The Madurai Intraocular Lens Study. III: Visual functioning and quality of life outcomes. Am Ophthalmol, 1998, 125(1): 26-35.
5.	Riaz Y, Mehta JS, Wormald R, et al. Surgical interventions for agerelated cataract. Cochrane Database of Systematic Reviews, 2002, Issue 2.
6.	Lira RP, Nascimento MA, Moreira-Filho DC, et al. Are routine preoperative medical tests needed with cataract surgery? Pan American Journal of Public Health, 2001, 10(1): 13-17.
7.	Foster A. Vision 2020: The cataract challenge. Community Eye Health Journal, 2007, 13(34): 17-19.
8.	Nascimento MA, Lira RP, Soares PH, et al. Are routine preoperative medical tests needed with cataract surgery? Study of visual acuity outcome. Curr Eye Res, 2004, 28(4): 285-290.
9.	Cavallini GM, Saccarola P, D’Amico R, et al. Impact of preoperative testing on ophthalmologic and systemic outcomes in cataract surgery. Euro J Ophthalmol, 2004, 14(5): 369-374.10 Schein OD, Katz J, Bass EB, et al. The value of routine preoperative medical testing before cataract surgery. Study of Medical Testing for Cataract Surgery. N Engl J Medi, 2000, 342(3): 168-175.
10.	Higgins JPT, Green S, editors. Assessing risk of bias in included studies . Cochrane Handbook for Sys temat ic Reviews of Interventions 5.0.0 [updated February 2008; Part 2 Chapter 8. In: The Cochrane Library, Issue 3, 2008. Chichester, UK: John Wiley & Sons, Ltd.
11.	吴泰相, 刘关键. 隐蔽分组(分配隐藏)和盲法的概念、实施与报告. 中国循证医学杂志, 2007, 7(3): 222-225.
12.	Roizen MF. More preoperative assessment by physicians and less by laboratory tests. N Engl J Med, 2000, 342: 204-205.
13.	American Society of Anestheiologists. New classification of physical status. Anesthesiology, 1963, 24: 111.
14.	Roizen MF. Preoperative evaluation. In: Miller RD, ed. Anesthesia.4th ed. Vol. 1. New York: Churchill Livingstone, 1994: 827-82.
15.	Narr BJ, Hansen TR, Warner MA. Preoperative laboratory screening in healthy Mayo patients: cost-effective elimination of tests and unchanged outcomes. Mayo Clin Proc, 1991, 66: 155-159.
16.	Pasternak LR. Screening patients: strategies and studies. In: McGoldrick KE, ed. Ambulatory anesthesiology: a problem-oriented approach. Baltimore: Williams & Wilkins, 1995: 2-19.
17.	Roizen MF, Kaplan EB, Schreider BD, et al. The relative roles of the history and physical examination, and laboratory testing in preoperative evaluation for outpatient surgery: the “Starling” curve of preoperative laboratory testing. Anesthesiol Clin North Am, 1987, 5: 15.
18.	Velanovich V. Preoperative laboratory evaluation. J Am Coll Surg, 1996, 183: 79-87.
19.	Marcello PW, Roberts PL. “Routine” preoperative studies: which studies in which patients? Surg Clin North Am, 1996, 76: 11-23.
20.	Kaplan EB, Sheiner LB, Boeckmann AJ, et al. The usefulness of preoperative laboratory screening. JAMA, 1985, 253: 3576-3581.
21.	Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the qual ity of reports of parallel-group randomized trials. The CONSORT statement: revised recommendations for improving the quality of reports of parallelgroup randomized trials. Lancet, 2001, 357: 1191-1194.

1. Davison M, Padroni S. Sub-Tenon’s anaesthesia versus topical anaesthesia for cataract surgery. Cochrane Database of Systematic Reviews, 18 July 2007 in Issue 3, 2007.
2. Alhassan MB, Kyari F. Peribulbar versus retrobulbar anaesthesia for cataract surgery. Cochrane Database of Systematic Reviews, 16 July 2008 in Issue 3, 2008.
3. Foster A. Cataract - a global perspective: output, outcome and outlay. Eye, 1999, 13: 449-453.
4. Fletcher A, Vijaykumar V, Selvaraj S, et al. The Madurai Intraocular Lens Study. III: Visual functioning and quality of life outcomes. Am Ophthalmol, 1998, 125(1): 26-35.
5. Riaz Y, Mehta JS, Wormald R, et al. Surgical interventions for agerelated cataract. Cochrane Database of Systematic Reviews, 2002, Issue 2.
6. Lira RP, Nascimento MA, Moreira-Filho DC, et al. Are routine preoperative medical tests needed with cataract surgery? Pan American Journal of Public Health, 2001, 10(1): 13-17.
7. Foster A. Vision 2020: The cataract challenge. Community Eye Health Journal, 2007, 13(34): 17-19.
8. Nascimento MA, Lira RP, Soares PH, et al. Are routine preoperative medical tests needed with cataract surgery? Study of visual acuity outcome. Curr Eye Res, 2004, 28(4): 285-290.
9. Cavallini GM, Saccarola P, D’Amico R, et al. Impact of preoperative testing on ophthalmologic and systemic outcomes in cataract surgery. Euro J Ophthalmol, 2004, 14(5): 369-374.10 Schein OD, Katz J, Bass EB, et al. The value of routine preoperative medical testing before cataract surgery. Study of Medical Testing for Cataract Surgery. N Engl J Medi, 2000, 342(3): 168-175.
10. Higgins JPT, Green S, editors. Assessing risk of bias in included studies . Cochrane Handbook for Sys temat ic Reviews of Interventions 5.0.0 [updated February 2008; Part 2 Chapter 8. In: The Cochrane Library, Issue 3, 2008. Chichester, UK: John Wiley & Sons, Ltd.
11. 吴泰相, 刘关键. 隐蔽分组(分配隐藏)和盲法的概念、实施与报告. 中国循证医学杂志, 2007, 7(3): 222-225.
12. Roizen MF. More preoperative assessment by physicians and less by laboratory tests. N Engl J Med, 2000, 342: 204-205.
13. American Society of Anestheiologists. New classification of physical status. Anesthesiology, 1963, 24: 111.
14. Roizen MF. Preoperative evaluation. In: Miller RD, ed. Anesthesia.4th ed. Vol. 1. New York: Churchill Livingstone, 1994: 827-82.
15. Narr BJ, Hansen TR, Warner MA. Preoperative laboratory screening in healthy Mayo patients: cost-effective elimination of tests and unchanged outcomes. Mayo Clin Proc, 1991, 66: 155-159.
16. Pasternak LR. Screening patients: strategies and studies. In: McGoldrick KE, ed. Ambulatory anesthesiology: a problem-oriented approach. Baltimore: Williams & Wilkins, 1995: 2-19.
17. Roizen MF, Kaplan EB, Schreider BD, et al. The relative roles of the history and physical examination, and laboratory testing in preoperative evaluation for outpatient surgery: the “Starling” curve of preoperative laboratory testing. Anesthesiol Clin North Am, 1987, 5: 15.
18. Velanovich V. Preoperative laboratory evaluation. J Am Coll Surg, 1996, 183: 79-87.
19. Marcello PW, Roberts PL. “Routine” preoperative studies: which studies in which patients? Surg Clin North Am, 1996, 76: 11-23.
20. Kaplan EB, Sheiner LB, Boeckmann AJ, et al. The usefulness of preoperative laboratory screening. JAMA, 1985, 253: 3576-3581.
21. Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the qual ity of reports of parallel-group randomized trials. The CONSORT statement: revised recommendations for improving the quality of reports of parallelgroup randomized trials. Lancet, 2001, 357: 1191-1194.

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Preoperative Routine Testings versus Selective Routine Testings in the Safty of Cataract Surgery: A Systematic Review

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