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Cataract patients may not need to fast before surgery

Can J Ophthalmol. 2009;44(6):655-656.

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Despite the long-standing use of fasting before any surgery, there appears to be little risk for aspiration pneumonia among patients undergoing cataract surgery, according to a study at a surgery center that does not require fasting before application of anesthesia.

Among 5,125 patients who underwent cataract surgery between April 1, 2007, and March 31, 2008, at Mount St. Joseph's Hospital, Vancouver, British Columbia, there were no cases of aspiration pneumonia. The retrospective review looked for cases of aspiration pneumonia — which can occur if stomach contents empty in an airway that has been compromised due to anesthesia medications — in three manners: anesthesiologist recall, operating room surgeon recall and a search of hospital records for admissions within 1 week of cataract surgery with a diagnosis of pneumonia.

According to the study, Mount St. Joseph's Hospital requires only that patients stop food and liquid intake for 1 hour before their cataract surgery. About 50% of patients at the center receive IV sedation and about 3% require infiltration anesthesia.