Can J Ophthalmol. 2019 Apr;54(2):145-149. doi: 10.1016/j.jcjo.2018.05.011. Epub 2018 Aug 23.
1. Faculty of Medicine, University of Toronto, Toronto, Ont.
2. Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.
3. Faculty of Science, York University, Toronto, Ont.
4. Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.. Electronic address: email@example.com.
Given the lack of policy standardization in Canada, this systematic review investigates the optimal duration of preoperative fasting in cataract surgery. A literature search was conducted on Ovid MEDLINE, with potential articles screened by 2 independent authors. The primary endpoint was the incidence of aspiration. Overall, 231 articles were screened, of which 6 were eligible. Two studies found no cases of aspiration in over 35 000 patients who underwent cataract surgery without preoperative fasting, some with intravenous sedation (50% in 1 series, less than 1% in the second). A survey of the British Ophthalmic Anaesthesia Society found that over 50% of centres did not require fasting before cataract surgery. Only 1 included report discussed a case of aspiration pneumonitis following cataract surgery with general anaesthesia and 14hours of preoperative fasting. In closing, further evidence is needed to delineate the risk of pulmonary aspiration based on fasting time in cataract surgery.