Postoperative IOP prophylaxis practice following uncomplicated cataract surgery: a UK-wide consultant survey.
BACKGROUND
In order to minimise postoperative intraocular pressure (IOP) rise, after routine uncomplicated cataract surgery, prophylaxis may be adopted. Currently, there are no specific guidelines in this regard resulting in wide variation in practice across the UK. We sought to document these variations through a questionnaire survey.


METHODS
A questionnaire was sent to all consultant ophthalmic surgeons in the UK.


RESULTS
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.


CONCLUSIONS
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.
Zamvar
Usha
U
Department of Ophthalmology, Stirling Royal Infirmary, Livilands, Stirling, UK. ushazamvar@hotmail.com
Dhillon
Baljean
B
D000086:Acetazolamide / Q000008:administration & dosage; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage; D006306:Health Surveys; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D019654:Lens Implantation, Intraocular; D009885:Ophthalmology / Q000706:statistics & numerical data*; D018918:Phacoemulsification; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom
D002257:Carbonic Anhydrase Inhibitors; D000086:Acetazolamide