Experience and Challenges in Intraocular Surgery in Patients With Kyphosis: A Cross-Sectional Survey Among Practicing...

The practice patterns for patient positioning, surgical techniques, and challenges faced by ophthalmologists during eye surgery on patients with kyphosis in India are yet unknown.

A cross-sectional online survey was conducted through Google Forms amongst practicing ophthalmic surgeons over two months and communicated across email lists and social media networks of state and regional ophthalmological associations of India in 2022.

Fifty-two ophthalmologists responded (mean age 48.6 ± 8.5 years, 71.2% males), mostly from teaching hospitals in urban areas of eastern India. Overall, 1279 cases of kyphosis were reported to have been operated upon. The majority had 30-50° of kyphosis. Peribulbar or retrobulbar anesthesia was equally preferred with an ophthalmic operating table for positioning. Almost equal numbers of surgeons operate sitting superiorly or temporally. More than half the respondents (57.7%) reported no difficulty or complications, and 71.2% did not alter their settings while performing phacoemulsification. The majority of the remainder had problems due to the high level of the patient's head, microscope oculars raised beyond their comfort level, and having to adjust their posture with every movement of a restless patient. Reaching the foot pedal while sitting or operating it while standing posed challenges. Surgeons commonly reported backache, neck pain, exhaustion, stiffness, tiredness, and mental stress.  Conclusions: Our study provides an Indian perspective on managing intraocular surgery in kyphotic patients with special requirements. Innovative solutions for positioning the patient and proficient surgeons can lead to the successful accomplishment of ocular surgery in such challenging patients.