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Published on: February 15, 2022
Postoperative guidelines following pediatric cataract and glaucoma surgeries: a survey of preferred surgeon
Angela M Ngo1, Courtney L Kraus2
1Georgetown University School of Medicine, Washington, DC.
Insights
Most ophthalmologists do not restrict children's activities long-term after intraocular surgery. Guidelines for pediatric cataract and glaucoma patients largely permit participation in sports and other activities post-recovery.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Public Health
Background:
- No standardized long-term postoperative activity guidelines exist for pediatric patients undergoing intraocular surgery.
- Ophthalmologists' practices vary regarding activity restrictions after childhood cataract and glaucoma surgeries.
Purpose of the Study:
- To survey ophthalmologists on their long-term postoperative activity guidelines for pediatric patients.
- To understand current practices for activity restrictions following childhood cataract and glaucoma surgeries.
Main Methods:
- An anonymous 28-question survey was distributed to ophthalmologists.
- The survey assessed guidelines for water-based, sports, and high-risk activities post-one month surgery.
- Guidelines were evaluated based on surgery type: cataract extraction, and various glaucoma procedures.
Main Results:
- Most ophthalmologists reported no long-term restrictions for water-based, sports, or high-risk activities.
- Surgical technique or clinical findings generally did not alter long-term restriction recommendations.
- For glaucoma surgeries, restrictions were more common than participation with protective eyewear; for cataract surgery, aphakic children were encouraged to wear safety glasses.
Conclusions:
- The majority of ophthalmologists do not impose long-term postoperative activity restrictions after pediatric intraocular surgeries.
- Current practices suggest a trend towards fewer activity limitations for children following these procedures.
Background:
Recommendations regarding long-term postoperative activity are intended to prevent adverse events, but no common policy or best practice exists among ophthalmologists for pediatric patients. We surveyed ophthalmologists on their postoperative guidelines after the one-month postoperative period following childhood cataract and glaucoma surgeries.
Methods:
A 28-question anonymous Qualtrics survey was distributed via listservs and social media. The survey was designed to elicit respondents' preferred long-term postoperative guidelines (after month 1) for participation in five water-based activities, nine sports, and three other "high-risk" activities, according to type of surgery: primary cataract extraction with or without intraocular lens (IOL) implantation, angle-based glaucoma surgeries, glaucoma drainage device surgeries, and glaucoma filtering surgeries.
Results:
A total of 49 responses were collected from June to August 2023. Most respondents reported no long-term postoperative restrictions for water-based activities (72%-84%), sports (47%-84%), or high-risk activities (72%-88%). Most respondents did not change their postoperative restrictions based on nuances of surgical technique or clinical examination, such as an "iris claw" IOL (79%), prior trauma (65%), contact lens removal (83%), eye pressure (86%-87%), or bleb appearance (80%). For glaucoma surgeries, although the majority allow complete participation, ophthalmologists were more likely to recommend complete restrictions than sports participation with protective eyewear. For cataract surgery, children with aphakia were more likely to be encouraged to wear safety glasses and less likely to have complete restriction of an activity than those with an IOL.
Conclusions:
Most ophthalmologists do not impose long-term postoperative restrictions following childhood intraocular surgeries.
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