Postoperative guidelines following pediatric cataract and glaucoma surgeries: a survey of preferred surgeon instructions.

Abstract

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.