Study characterizes pediatric immediate sequential bilateral cataract surgery
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Pediatric ophthalmologists reported more frequently performing immediate sequential bilateral cataract surgery in infants and children younger than 10 years, according to a presentation at the American Academy of Ophthalmology meeting.
Erin L. Dohaney, MD, and colleagues conducted a 33-item worldwide online survey among 126 ophthalmologists between March and April 2021 and reviewed existing literature on pediatric immediate sequential bilateral cataract surgery (ISBCS).
Fifty-eight percent of surgeons who reported performing cataract surgery in children younger than 10 years use ISBCS, according to the abstract. In comparison, 21% of surgeons who performed cataract surgery in children between ages 10 and 18 years used ISBCS.
According to the presentation, there were no significant associations between performing ISBCS and age, years in practice, practice setting or geographic location.
The 63 ophthalmologists who reported using ISBCS in pediatric patients cited reduced exposure to general anesthesia (81%) and reduced amblyopia risk (56%) as “quite important” or “very important” reasons for their choice. Among those who did not perform ISBCS, 86% ranked concerns about safety and bilateral vision-threatening complications as “quite important” or “very important.”
The researchers found 33 published studies on pediatric ISBCS and identified a need for greater study design variety, larger study population sizes, quantification of endophthalmitis risk vs. anesthesia risk, and updated guidelines and preferred practice patterns.
Intracameral antibiotics, which are recommended in bilateral cataract surgery by the International Society of Bilateral Cataract Surgeons, “have been shown to dramatically reduce the risk of postoperative endophthalmitis,” the study authors wrote.
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Dohaney EL, et al. Pediatric immediate sequential bilateral cataract surgery: A scoping review and survey of pediatric ophthalmologists. Presented at: American Academy of Ophthalmology meeting; Nov. 12-15, 2021; New Orleans.
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