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Postoperative IOP prophylaxis practice following uncomplicated cataract surgery: a UK-wide consultant survey

DOI: 10.1186/1471-2415-5-24

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Abstract:

A questionnaire was sent to all consultant ophthalmic surgeons in the UK.62.6% of surgeons did not use any IOP lowering agents. 37.4% surgeons routinely prescribed some form of medication. The majority (86.8%) used oral diamox. 20.6% of surgeons said they based their practice on evidence, 43.3% on personal experience, and 17.6% on unit policy. Surprisingly, among the two groups of surgeons (those who gave routine prophylaxis, and those who did not) the percentages of surgeons quoting personal experience, unit policy, or presence of evidence was strikingly similar. The timing of the first postoperative IOP check varied from the same day to beyond 2 weeks. Only 20.2% of surgeons had ever seen an adverse event related to IOP rise; this complication is thus very rare.This survey highlights a wide variation in the practice and postoperative management of phacoemulsification cataract surgery. What is very striking is that there is a similar proportion of surgeons in the diametrically opposite groups (those who give or do not give routine IOP lowering prophylaxis) who believe that there practice is evidence based. The merits of this study suggests that consideration must be given to drafting a uniform guideline in this area of practice.Phacoemulsification and intra-ocular lens implantation (PhIOL) is one of the most cost-effective, elective surgical interventions. In order to minimise postoperative intraocular pressure (IOP) rise, prophylaxis may be adopted. Currently, there are no specific guidelines for prophylaxis in uncomplicated cataract surgery. We studied current prophylaxis practice in a UK-wide survey which showed wide variation in prophylaxis practice.We conducted a pilot, self-administered postal-based survey of the Scottish ophthalmic consultants. The results of this survey suggested variation in prophylaxis practice for IOP rise, duration until 1st IOP monitoring, and management of elevated IOP following uncomplicated phacoemulsification with intraocular lens

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