Does vitreoretinal surgery under local anaesthesia result in missed fellow eye pathology?

Purpose There has been a significant increase in the number of vitreoretinal procedures being performed under local anaesthesia over the past few years. This trend is expected to continue. This study was performed to investigate whether by undertaking retinal detachment surgery under local anaesthesia fellow eye examination was compromised. Design This was a prospective, consecutive, blind, observational study. Methods: Setting This study was performed at a tertiary referral vitreoretinal unit in a teaching hospital. Study population In all, 108 consecutive patients undergoing retinal detachment surgery under general anaesthesia were included. Observation procedures Patients were examined independently by different retinal surgeons pre- and intraoperatively. Main outcome measures The findings of the two examiners were compared and differences were analysed. Results There were 108 patients in this study, 57 of these were males and 51 females. The mean age was 59.01 years (range 16–91). Of these 108 eyes, 48/108 (49.08%) the preoperative examination was regarded as unsatisfactory by the examiner. Over 34% of eyes had fellow eye pathology when examined preoperatively but there were nine (8.33%) eyes in which additional lesions were found intraoperatively. Conclusion General anaesthesia should be considered for patients in whom preoperative fellow eye examination is unsatisfactory.