Prediction of perioperative complications and registration of outcomes in ophthalmic surgery: current state of the problem

The purpose of the work is to summarize modern approaches to predicting systemic perioperative complications in ophthalmic surgery, to assess the possibilities of using preoperative risk calculators and to determine the role of clinical registries in ensuring the safety of surgical treatment.

Material and methods. The review includes domestic and foreign publications from 2020–2025, selected from the PubMed, Scopus and Web of Science databases, as well as materials from existing national and international registries (EUREQUO, IRIS, etc.). Particular attention is paid to assessing the limitations of traditional risk scales (ASA, RCRI), the role of markers of the activity of the neurovegetative system (heart rate variability — HRV and baroreflex sensitivity — BRS), as well as the potential of artificial intelligence (AI) in the development of personalized prognostic models.

Results. It was found that ophthalmic surgery, despite the low-trauma nature of the interventions, is associated with the risk of critical incidents, especially in elderly patients with a comorbid background. Known risk stratification scales do not take into account physiological predictors and are of little use when used in ophthalmic surgery. HRV and BRS have high prognostic value, but are not integrated into the models used. AI algorithms, including machine learning systems and the concept of digital twins, allow combining clinical and physiological parameters and forming personalized risk profiles.

Conclusion. The presented data confirm the need to develop specialized ophthalmic risk calculators and clinical registries that include phys iological parameters. Integration of AI into the processes of risk stratification of systemic perioperative complications and critical incidents helps to improve the safety of ophthalmic surgery in high-risk patients.

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