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Immediate sequential bilateral cataract surgery saves time, resources
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SAN DIEGO — Immediate sequential bilateral cataract surgery in children can save time and resources without postoperative ophthalmological or anesthesia-related complications, according to a speaker.
“Immediate sequential surgery in children has the potential to avoid multiple anesthesia and hospital admissions. It can reduce postop follow-up visits. It can improve convenience and compliance of parents and cause cost savings to both parents and health care systems without an increased incidence of complications,” Vishaal Bhambhwani, MD, said at the American Association for Pediatric Ophthalmology and Strabismus annual meeting.
Bhambhwani and colleagues from the University of Toronto conducted a study to compare the outcomes and complications of immediate vs. delayed sequential cataract surgery in children younger than 2 years old.
The retrospective review evaluated postoperative health records over a 10-year period of 53 children who underwent either immediate or delayed sequential bilateral cataract surgery. Parents decided which surgery they wanted for their child. Thirty-seven children were included in the immediate group and 16 in the delayed group.
Even though there were no significant differences in demographics between the two groups, the immediate group included 13 children with systemic and ocular associations compared with one in the delayed group (P = .029). Correspondingly, the ASA grade in the immediate group was also statistically significantly higher (P = .034).
All children underwent lensectomy with anterior vitrectomy, most without IOL implantation.
Even though the immediate group had more complex children with technically challenging cataracts and higher ASA grade, there were no major operative or anesthetic complications in either group. Extra surgical maneuvers were required in the immediate group, but operating room time was still statistically significantly less than for the delayed group (P = .037).
“The number of follow-up visits up to 8 weeks in the postoperative period was lower in the immediate sequential group so that the parents had to come to the hospital less,” Bhambhwani said. “And even though the immediate group had more complex children, the complication rate was actually a little bit higher in the delayed group, but there was no endophthalmitis and no TASS in either group.” – by Patricia Nale, ELS
Reference:
Bhambhwani V. Outcomes and complications of immediate versus delayed sequential bilateral cataract surgery in children. Presented at: American Association for Pediatric Ophthalmology and Strabismus annual meeting; March 28 to 31, 2019; San Diego.
Disclosure: Bhambhwani reports no relevant financial disclosures.