Ophthalmic anesthesia is generally safe, but complications c
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A retrospective analysis studied anesthesia-related closed claims and their contributing factors using data from Ophthalmic Mutual Insurance Company (OMIC). Investigators analyzed 63 closed anesthesia-related claims or suits ?led by 50 plaintiffs over a 10-year period. Plaintiffs who filed a professional liability claim or suit against an OMIC-insured ophthalmologist, ophthalmic practices or surgicenters where the case occurred were included.

Outcomes
Globe perforation (n=17) was the most common injury, followed by death (n=13), retrobulbar hemorrhage (n=7) and optic nerve damage (n=4). Two deaths were related to brainstem anesthesia. Most of the plaintiffs who died had known medical problems, including diabetes mellitus and atherosclerotic cardiovascular disease.

The type of anesthesia that led to these claims or suits was primarily retrobulbar and peribulbar anesthesia (n=16 each, 32 total). Ophthalmologists administered the retrobulbar or peribulbar injection in 27 of 32 (84%) of closed-claim cases, anesthesiologists in 3 (9%) and certified registered nurse anesthetists in 2 (6%). Retina procedures accounted for the second most claims (24%) after cataract surgery (n=24).

Clinical significance
The authors conclude that anesthesia-related claims and suits are uncommon, but anesthesia-related complications can lead to severe injuries. They list several actionable steps that may be taken to limit anesthesia-related complications during ocular surgery.

Source: https://www.aao.org/editors-choice/ophthalmic-anesthesia-is-generally-safe-complicati
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