Preoperative Medication Disclosure Failure Leads to Postoperative Complications

Case Overview

This case study involves an adult patient who underwent a series of ophthalmologic procedures, including phacoemulsification, canaloplasty, and goniotomy. Subsequent to these surgeries, the patient experienced elevated intraocular pressure (IOP) and severe discomfort.

It was later discovered that the performing physician was not informed about the patient's ongoing Plavix medication during the time of the surgeries. This raises questions regarding the standard of care provided and whether incomplete medical history disclosure could have contributed to postoperative complications.

Questions to the Ophthalmology expert and their responses

How frequently do you perform ophthalmologic procedures such as phacoemulsification, canaloplasty, and goniotomy?

As a comprehensive ophthalmologist, I handle 8-15 eye surgery cases in the operating room every week. These include a mixture of cataract surgery, glaucoma, cornea, and oculoplastics cases.

What are the most pertinent measures that physicians can take to minimize the incidence of elevated intraocular pressure in patients undergoing ophthalmologic procedures like phacoemulsification, canaloplasty, and goniotomy?

The procedures mentioned—canaloplasty and goniotomy—are typically performed when intraocular pressures are already elevated. However, several factors can contribute to raised IOP following cataract and other surgeries. These include failure to adequately remove surgical viscoelastic material, retained lens material, and steroid-response.

Have you ever reviewed a similar case? If yes, please elaborate.

I have reviewed similar cases involving postoperative complications after ophthalmologic procedures. However, each case is unique and requires a thorough review of the medical records.

About the expert

This expert is a seasoned ophthalmologist with over two decades of experience in the field. They hold an impressive academic background, including an MD from a prestigious Ivy League institution and board certification in ophthalmology. Their extensive involvement in academia, professional organizations, and leadership roles in comprehensive ophthalmology at renowned medical centers, coupled with their current position at a major VA medical center, underscores their expertise and relevance to this case study.

E-420833

Specialties:

Ophthalmology

About the author

Wendy Ketner, M.D.

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.