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Effect of Caffeine Intake on Retinal Microsurgical Performance

Andrea Elizabeth Arriola-Lopez, Virgilio Morales-Canton, Gerardo Garcia-Aguirre, Guillermo Salcedo-Villanueva, Jose Dalma-Weiszhausz and Raul Velez-Montoya

Objective: To assess the effects of prior caffeine intake on tremor control and internal limiting membrane peeling proficiency of experienced retinal surgeons using a microsurgical simulator. Methods: Experienced vitreoretinal surgeons were included. On two separate days, each subject underwent a test on a level 4 anti-tremor test and internal limiting membrane peeling test on a microsurgical simulator (Eye-Si/ Series 199, VRMagic, Sofware 2.9, Mannheim, Germany) first with no caffeine intake and after 40 minutes of taking an oral dose of caffeine (200 mg and 400 mg). Each subject underwent blood pressure and heart rate measurements before and 40 min after caffeine intake. The same technician measured both surgical performances. Results: Mean age was 46.4 ± 10.1 years. All subjects were male. The mean anti-tremor results were: baseline scores 61.2 ± 19.15, 200 mg 61.6 ± 12.63 and 400 mg 75.4 ± 15.09. The mean internal limiting membrane peeling results were: baseline score 55.9 ± 5.46, 200 mg 54.8 ± 10.05 and 400 mg 62.6 ± 9.63. Blood pressure and heart rate remained stable. After consumption of higher doses of caffeine some adverse effects were reported such as headache and a transient episode of anxiety. Conclusion: Caffeine consumption prior to surgery is discouraged by microsurgeons due to potential adverse effects. Our results showed no significant change on the surgical ability after 200 and 400 mg of oral caffeine. There was a non-significant improvement on the overall score after 400 mg.