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Vitreoretinal surgery
Vitreoretinal surgical performance after acute alcohol consumption and hangover
  1. Marina Roizenblatt1,2,
  2. Peter Louis Gehlbach2,
  3. Vitor Dias Gomes Barrios Marin1,
  4. Arnaldo Roizenblatt1,
  5. Thiago Marques Fidalgo3,
  6. Vinicius Silveira Saraiva1,
  7. Mauricio Hiroshi Nakanami1,
  8. Luciana Cruz Noia1,
  9. Sung Watanabe1,
  10. Erika Sayuri Yasaki1,
  11. Renato Magalhães Passos1,
  12. Octaviano Magalhães Junior1,
  13. Rodrigo Antonio Brant Fernandes4,
  14. Francisco Rosa Stefanini1,
  15. Rafael Caiado1,
  16. Kim Jiramongkolchai5,
  17. Michel Eid Farah1,
  18. Rubens Belfort Junior1,
  19. Mauricio Maia1
  1. 1Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
  2. 2Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
  3. 3Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
  4. 4Department of Ophthalmology, USC Keck School of Medicine, Los Angeles, California, USA
  5. 5Kaiser Permanente Medical Center, Mclean, Virginia, USA
  1. Correspondence to Dr Marina Roizenblatt; maroizenb{at}gmail.com

Abstract

Aim Routine alcohol testing of practicing physicians remains controversial since there are no uniform guidelines or legal regulations in the medical field. Our aim was to quantitatively study the acute and next-morning effects of breath alcohol concentration (BAC)-adjusted alcohol intake on overall simulated surgical performance and microtremor among senior vitreoretinal surgeons.

Methods This prospective cohort study included 11 vitreoretinal surgeons (>10 years practice). Surgical performance was first assessed using the Eyesi surgical simulator following same-day alcohol consumption producing a BAC reading of 0.06%–0.10% (low-dose), followed by 0.11%–0.15% (high-dose). Dexterity was then evaluated after a ‘night out’ producing a high-dose BAC combined with a night’s sleep. Changes in the total score (0–700, worst-best) and tremor (0–100, best-worst) were measured.

Results Surgeon performance declined after high-dose alcohol compared with low-dose alcohol (−8.60±10.77 vs −1.21±7.71, p=0.04, respectively). The performance during hangover was similar to low-dose alcohol (−1.76±14.47 vs −1.21±7.71, p=1.00, respectively). The performance during hangover tended to be better than after high-dose alcohol (−1.76±14.47 vs −8.60±10.77, p=0.09, respectively). Tremor increased during hangover compared with low-dose alcohol (7.33±21.65 vs −10.31±10.73, p=0.03, respectively). A trend toward greater tremor during hangover occurred compared with high-dose alcohol (7.33±21.65 vs −4.12±17.17, p=0.08, respectively).

Conclusion Alcohol-related decline in simulated surgical dexterity among senior vitreoretinal surgeons was dose-dependent. Dexterity improved the following morning but remained comparable to after low-dose alcohol ingestion. Tremor increased during hangover compared with same-day intoxication. Further studies are needed to investigate extrapolations of these data to a real surgical environment regarding patient safety and surgeon performance.

  • Retina
  • Treatment Surgery
  • Pharmacology

Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/bjo-2023-324044

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    Data availability statement

    Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Funding MR: Lemann Foundation, Instituto de Visão-IPEPO, Latinofarma. CAPES-Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. PLG: Research to Prevent Blindness, New York, USA, and gifts from the J Willard and Alice S Marriott Foundation, the Gale Trust, Herb Ehlers, Bill Wilbur and Rajandre Shaw, Helen Nassif, Mary Ellen Keck, Don and Maggie Feiner, and Ronald Stiff. MM and RBJ: CNPq – National Council for Scientific and Technological Development.

    • Competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

    • Provenance and peer review Not commissioned; externally peer reviewed.