Preoperative Medical Testing in Medicare Patients Undergoing Cataract Surgery

Routine preoperative testing is not recommended before cataract surgery. In this analysis of Medicare claims data, preoperative testing was common and varied widely among ophthalmologists; the ophthalmologist performing the surgery was the strongest predictor of testing. Cataract surgery is the most common elective surgery among Medicare beneficiaries, with 1.7 million procedures performed annually. 1 It is also very safe, with less than a 1% risk of major adverse cardiac events or death. 2 The mean duration of cataract surgery is 18 minutes, 3 and virtually all surgical procedures are performed in an ambulatory setting with topical anesthesia. 4 However, because patients are typically elderly with multiple coexisting conditions, 5 , 6 physicians frequently order routine preoperative tests because of concerns about patient safety, worries about medicolegal risks, and the perception that other physicians expect preoperative testing. 6 , 7 Despite these common justifications, previous . . .