Re: Koolwijk et al.: Outpatient cataract surgery: incident and procedural risk analysis do not support current clinical ophthalmology guidelines (Ophthalmology 2015;122:281-7)

The article by Koolwijk et al1 is welcomed, but we believe the title should be reworded. The authors looked at nearly 7000 consecutive cataract operations using topical/intracameral anesthesia without sedation, and concluded that “Cataract surgery can be safely performed in an outpatient clinic, in the absence of the anesthesia service and with limited workup and monitoring. Basic first aid and basic life support skills seem to be sufficient in case of an adverse event. A medical emergency team provides a generous fail-safe for this low-risk procedure.” We generally agree with this conclusion, but disagree with the title, which states that “Incident and Procedural Risk Analysis Do Not Support Current Clinical Ophthalmology Guidelines.”