Abstract
Purpose:
To study and establish a community standard for the use of antibiotics in cataract surgery. To identify the practices and preferences of San Antonio ophthalmologists as they relate to cataract surgery.
Methods:
A 20 question survey was administered to San Antonio ophthalmologists. It was distributed to all University of Texas Health Science Center at San Antonio(UTHSCSA) ophthalmologists as well as to members of the San Antonio Society of Ophthalmology(SASO). Surveys were administered by email and in person. The email version was administered through a link to an online survey at surveymonkey.com. IRB approval was obtained through UTHSCSA.
Results:
Anesthesia was reportedly given by a retro or peribulbar technique 47.7% of time, compared with 43.5% for topical/intracameral. General anesthesia was only used 4.5% of the time.<br /> Clear cornea incision was identified as the preferred method of primary wound formation 86.6% of the time, followed by scleral tunnel at 11.7%. These wounds were closed with wound hydration 82.2% of the time and with suture 17.8%.<br /> Preoperatively 79.2% of physicians report using antibiotic drops for a time period ranging from one drop on the day of surgery to several days of drops. The other 20.8% of surgeons did not give antibiotics in the preoperative setting. Intraoperatively 50% of surgeons gave topical antibiotics, 29.2% intracameral, 25% subconjunctival, 8.3% subtenons and 29.2% did not use antibiotics at this stage. No one reported giving IV antibiotics at any point and no one used antibiotics in their irrigating solution. Postoperatively 100% of surgeons prescribed topical antibiotics.<br /> All of the physicians surveyed routinely prepped with povidone-iodine prior to surgery, 20.8% reported employing 2 or more applications. In cases of iodine allergy 37.5% of surgeons said they still use povidone-iodine, and another 8% perform a skin test.
Conclusions:
Through this research we have identified the general styles and preferences of local San Antonio ophthalmologists. Our results demonstrate the community standard for antibiotic and anesthetic use in cataract surgery. We also believe that this research helps provide a picture of the national landscape and highlights current trends in cataract surgery. It will be useful for physicians in training as they enter the work force.