Lifetime Smokers More Likely to Have Complications After Orbitotomies

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The investigation also shows men are at elevated risk of chronic postoperative pain, hemorrhaging, infection, and wound contracture.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 Fall Scientific Symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery, held in New Orleans from November 11 to 12, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the oculoplastic researchers and other clinicians at the ASOPRS. Check back for more from the ASOPRS 2021 Fall Scientific Symposium.

Lifetime smoking history is associated with higher risk of complications following enucleations and orbitotomies, researchers reported in a study they presented at the American Society of Ophthalmic Plastic and Reconstructive Surgery 52nd Annual Fall Scientific Symposium in New Orleans, November 11-12.

The researchers sought to determine what risk factors may increase complications following oculoplastic surgeries. A prior study indicated men are at higher risk of wound dehiscence in upper blepharoplasty.

Researchers reviewed the data in the University of Washington Medicine medical records of adult patients who underwent oculoplastic CPT codes for common ptosis repair, lacrimal system, orbital, and globe removal surgeries. Patients with pre-existing local infection or trauma or diagnosis of non-DM endocrine disorders were excluded.

They analyzed the influence of diabetic status and HbA1c, age, sex, body mass index (BMI), lifetime smoking history, hypertension (HTN), heart disease, and chronic kidney disease (CKD) on peri- and post-operative surgical site complications. They calculated odds ratios of complication rates for the risk factors through Fisher’s exact test and two-tailed t-tests.

The study examined 2208 patients (54.4% women 73.7% White) and 2610 surgeries, including dacryocystorhinostomy (DCR), enucleation, evisceration, exenteration, and mullerectomy. There were 57 surgical complications (2.2%). Chronic postoperative pain, hemorrhage, infection, and wound contracture were among those complications.

The researchers found that lifetime smoking more than tripled the odds of complications following orbitotomy (OR 3.306 95% CI 1.414 to 7.982 P =.0118) and more than quadrupled the odds of complications after enucleation (OR 4.409 95% CI 1.404 to 13.61 P =.0324).

Men were more than five times more likely to experience complications following orbitotomy compared with women (OR 5.407 95% CI 1.631 to 17.41 P =.0021).

Smoking is a modifiable risk factor,” the investigators said. “This study may serve to provide oculoplastic surgeons with evidence to guide pre-op conversations and patient education.”

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Nathe C, Li E, Lu GN, et al. Risk factors for surgical complications in oculoplastic surgery. Poster presented at ASOPRS 52nd Annual Fall Scientific Symposium; November 11-12, 2021; New Orleans.