Dr. Lane recently spoke at the Toronto Cataract Course on February 22nd, 2020 about a new technique to allow patients to have cataract surgery who cannot lie flat due to severe shortness of breath.
Typically, these patients have severe lung or heart disease, and would be denied cataract surgery.
With this new technique, however, many of these patients can now have cataract surgery.
This technique involves using a special breathing device called Optiflow (continuous high flow oxygen therapy).
Optiflow is a special system for delivering high flow rates of heated, humidified, oxygen to patients who are short of breath.
Usually, Optiflow is used in the hospital setting as a “bridge” from the ICU (people who have breathing tubes removed, who are then transferred to a regular hospital bed, but still are unable to breathe on their own). It can also be used for patients with pneumonia (to help mobilize secretions), or in patients who have had major abdominal surgery, who find it difficult to take large breaths.
This unique system warms the oxygen, and adds moisture, which makes it much more comfortable for the patient to tolerate the high flow rates.
Usually, patients using nasal prongs oxygen (standard home oxygen delivery system) would use flow rates of 3-4 l/min.
This new system supplies up to 60 l/min. which takes the work out of breathing for these people, and allows them to lie flat without getting short of breath.
Credit Goes To Dr. Andrew Knox
Dr. Lane gave credit for this new idea in cataract surgery to Dr. Andrew Knox (Chief of Anesthesia, Ross Memorial Hospital, Lindsay), and thanked the department of Respiratory Therapy for their help with these challenging cases.
Dr. Lane was most impressed by this new technique, and was happy for the opportunity to share it with other ophthalmologists in Canada and US attending the conference. This new technique for managing patients with severe shortness of breath gives hope to those patients who would normally be turned down for cataract surgery.