Same-day Cataract Surgery Should Not Be the Standard of Care for Patients With Bilateral Visually Significant Cataract

Henderson, Bonnie An; Schneider, Júlia

doi:10.1016/j.survophthal.2012.05.001

Cited by 53 publications

(55 citation statements)

References 19 publications

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“…7 However, it still remains quite controversial 3,8 as one of the main reasons is risk of bilateral endophthalmitis, which could lead to bilateral visual loss. The reported incidence of endophthalmitis following simultaneous bilateral cataract surgery is between 0.15 and 1.1%, as compared with 0.1% or less following unilateral or sequential cataract extractions.…”

Section: Discussionmentioning

confidence: 99%

“…Vascularly active is defined as the presence of plus disease with active new vessels. Giving a gap of 2-3 weeks between vitrectomy for both eyes, to prevent devastating complications like bilateral endophthalmitis, 3 could be disastrous for the second eye as the progression of retinal detachment in these cases is very fast and can quickly end in stage 5 ROP and blindness. Also giving general anaesthesia again within a short duration could be risky in these preterm children.…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of simultaneous bilateral 25-gauge lens-sparing vitrectomy for vascularly active stage 4 retinopathy of prematurity

Shah

Narendran

2015

Eye

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Purpose To report the safety and efficacy of simultaneous bilateral 25-gauge lens-sparing vitrectomy for vascularly active stage 4 retinopathy of prematurity (ROP). Methods Retrospective, noncomparative, consecutive case series. Twenty eyes of 10 babies who presented with vascularly active stage 4 ROP in both the eyes underwent simultaneous bilateral 25-gauge lens-sparing vitrectomy. After completing surgery for one eye, the other eye was re-prepped as performed before starting any new case of a different patient and an entire new set of disposable 25-gauge instruments were used. During the post-operative period parents were advised to keep separate eye drops for each eye and to wash their hands in between switching the eyes to put the drops. Results The mean follow-up was 8.7 months (range 4-17 months). None of the cases developed any signs of infection. The anatomic success rate for stage 4a was 100% (11/11 eyes) and for stage 4b was 8/9 eyes (89%). Conclusion These results show that simultaneous bilateral 25-gauge lens-sparing vitrectomy for stage 4 ROP is a safe and effective procedure with a good outcome provided both eyes of the baby are treated as eyes of two different patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of simultaneous bilateral 25-gauge lens-sparing vitrectomy for vascularly active stage 4 retinopathy of prematurity

Shah

Narendran

2015

Eye

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“…This is the standard of care for intraocular surgery in most countries, primarily because of concerns regarding potential complications such as endophthalmitis and toxic anterior segment syndrome. 6–8 Interestingly, bilateral intravitreal injections are performed routinely in many practices, and injections have similar rates of endophthalmitis compared with intraocular surgeries. 9,10 …”

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confidence: 99%

Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery

Yonekawa

Kusaka

et al. 2016

Ophthalmology

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Purpose To determine the feasibility and safety of bilateral simultaneous vitreoretinal surgery in pediatric patients. Design International, multicenter, interventional, retrospective case series. Participants Patients 17 years of age or younger from 24 centers worldwide who underwent immediate sequential bilateral vitreoretinal surgery (ISBVS)—defined as vitrectomy, scleral buckle, or lensectomy using the vitreous cutter—performed in both eyes sequentially during the same anesthesia session. Methods Clinical history, surgical details and indications, time under anesthesia, and intraoperative and postoperative ophthalmic and systemic adverse events were reviewed. Main Outcome Measures Ocular and systemic adverse events. Results A total of 344 surgeries from 172 ISBVS procedures in 167 patients were included in the study. The mean age of the cohort was 1.3±2.6 years. Nonexclusive indications for ISBVS were rapidly progressive disease (74.6%), systemic morbidity placing the child at high anesthesia risk (76.0%), and residence remote from surgery location (30.2%). The most common diagnoses were retinopathy of prematurity (ROP; 72.7% [P < 0.01]; stage 3, 4.8%; stage 4A, 44.4%; stage 4B, 22.4%; stage 5, 26.4%), familial exudative vitreoretinopathy (7.0%), abusive head trauma (4.1%), persistent fetal vasculature (3.5%), congenital cataract (1.7%), posterior capsular opacification (1.7%), rhegmatogenous retinal detachment (1.7%), congenital X-linked retinoschisis (1.2%), Norrie disease (2.3%), and viral retinitis (1.2%). Mean surgical time was 143±59 minutes for both eyes. Higher ROP stage correlated with longer surgical time (P=0.02). There were no reported intraoperative ocular complications. During the immediate postoperative period, 2 eyes from different patients demonstrated unilateral vitreous haemorrhage (0.6%). No cases of endophthalmitis, choroidal hemorrhage, or hypotony occurred. Mean total anesthesia time was 203±87 minutes. There were no cases of anesthesia-related death, malignant hyperthermia, anaphylaxis, or cardiac event. There was 1 case of reintubation (0.6%) and 1 case of prolonged oxygen desaturation (0.6%). Mean follow-up after surgery was 103 weeks, and anatomic success and globe salvage rates were 89.8% and 98.0%, respectively. Conclusions This study found ISBVS to be a feasible and safe treatment paradigm for pediatric patients with bilateral vitreoretinal pathologic features when repeated general anesthesia is undesirable or impractical.

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“…Nevertheless, until now ISBCE has remained an exception. Ophthalmic surgeons state that the fear of bilateral sight-threatening complications, especially potentially devastating outcome of bilateral endophthalmitis is the limiting factor [8]. However, there have only been four cases of simultaneous bilateral endophthalmitis ever published [3] and all had breached the aseptic protocol published by the International Society of Bilateral Cataract Surgeons (ISBCS) [9].…”

Section: Discussionmentioning

confidence: 99%

“…With an aging population these considerations will be of increased importance, particularly in an era where health care is obliged to focus on cost efficiency. Some surgeons clearly favor ISBCE because of its rapid visual rehabilitation and obvious practicalities for elderly patients and will perform it on request in the absence of contraindications [7]; however many are hesitant to adopt this methodology, due to the potential risk of bilateral retinal detachment, bilateral corneal decompensation, severe cystoids macular oedema, significant IOL power errors in the first eye that could be refined and thereby prevented in the second eye, and bilateral toxic anterior segment syndrome (TASS) [8].…”

Section: Introductionmentioning

confidence: 99%

More than 10 Years of Experience with Immediate Sequential Bilateral Cataract Extraction (ISBCE)—A Retrospective Study

Guber¹,

Bergin²,

Stürmer³

2014

OJOph

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Same-day Cataract Surgery Should Not Be the Standard of Care for Patients With Bilateral Visually Significant Cataract

Cited by 53 publications

References 19 publications

Safety and efficacy of simultaneous bilateral 25-gauge lens-sparing vitrectomy for vascularly active stage 4 retinopathy of prematurity

Safety and efficacy of simultaneous bilateral 25-gauge lens-sparing vitrectomy for vascularly active stage 4 retinopathy of prematurity

Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery

More than 10 Years of Experience with Immediate Sequential Bilateral Cataract Extraction (ISBCE)—A Retrospective Study

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