Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Ophthalmologists' Opinions and Practices in Türkiye Regarding Immediate Sequential Bilateral Cataract Surgery: A Survey Study: Cross Sectional Study
Türkiye'deki Oftalmologların Hemen Ardışık Bilateral Katarakt Cerrahisine İlişkin Görüş ve Uygulamaları: Bir Anket Çalışması: Kesitsel Araştırma
Berire Şeyma DURMUŞ ECEa , Zübeyir YOZGATa , Mehmet Uğur IŞIKa , Erdem YÜKSELb
aKastamonu University Faculty of Medicine, Department of Ophthalmology, Kastamonu, Türkiye
bGazi University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye
Turkiye Klinikleri J Ophthalmol. 2025;34(1):1-11
doi: 10.5336/ophthal.2024-104173
Article Language: EN
Full Text
ABSTRACT
 Objective: To evaluate the opinions and practices of ophthalmologists in Türkiye about immediate sequential bilateral cataract surgery (ISBCS) through an online survey. Material and Methods: The ISBCS survey was sent to ophthalmologists with accessible contact information in Türkiye. This survey examined ophthalmologists' concerns, case selection, reasons for reluctance, and factors that could potentially influence their practices. Results: 169 (43.7%) of the 389 survey recipients participated. 35 (20.7%) participants reported performing ISBCS, while 130 (76.9%) reported not performing ISBCS. 4 (2.4%) participants reported they had previously performed ISBCS but no longer did. Ophthalmologists with over 10 years of professional experience exhibited a significantly higher preference for ISBCS (p=0.027). It was determined that the patient's difficulty in reaching the hospital and the availability of separate surgical instruments for the right and left eyes were important factors for preferring ISBCS. Among ophthalmologists performing ISBCS, it was found that the majority preferred to use ISBCS specifically for senile cataract surgeries performed under high-risk general anesthesia. The main reasons why ophthalmologists didn't do ISBCS were the risk of endophthalmitis (87.6%) and medicolegal issues (86.9%). Conclusion: The majority of ophthalmologists in Türkiye do not perform ISBCS, approximately 20% do. For ophthalmologists, ISBCS is a concern for medicolegal considerations. Although a small percentage of ophthalmologists firmly stated that they would never perform ISBCS under any circumstances, there is generally a positive attitude towards ISBCS when specific conditions are met. To ensure eligible patients can benefit from ISBCS, assessing the existing barriers and developing national and international guidelines is crucial.

Keywords: Cataract; phacoemulsification; survey
ÖZET
 Amaç: Bu çalışmada, Türkiye'deki oftalmologların hemen ardışık bilateral katarakt cerrahisi [immediate sequential bilateral cataract surgery (ISBCS)] hakkındaki görüş ve uygulamalarının bir anket aracılığıyla değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: ISBCS uygulamaları ile ilgili anket, Türkiye'de oftalmolog olarak çalışan ve iletişim bilgileri erişilebilir olan göz doktorlarına gönderildi. Anket metni oftalmologların endişelerini, vaka seçimini, ISBCS hakkındaki isteksizlik nedenlerini ve ISBCS uygulamalarını potansiyel olarak etkileyebilecek faktörleri incelemek üzere tasarlandı. Bulgular: Anket metni 389 kişiye ulaştırıldı ve 169 (%43,7) kişi ankete katılım sağladı. Katılımcıların 35'i (%20,7) ISBCS yaptığını, 130'u (%76,9) ise ISBCS yapmadığını bildirdi. Dört (%2,4) katılımcı daha önce ISBCS yaptığını ancak artık yapmadığını söyledi. On yıldan fazla mesleki deneyimi olan göz doktorlarının ISBCS'si anlamlı yüksek tercih ettiği saptandı (p=0,027). Hastanın hastaneye ulaşımının zorluğu, sağ ve sol göz için ayrı cerrahi aletlerin bulunmasının ISBCS'yi tercih etmede önemli faktörler olduğu belirlendi. ISBCS uygulayan göz doktorları arasında çoğunluğun ISBCS'yi özellikle yüksek riskli genel anestezi altında yapılan senil katarakt ameliyatları için tercih ettiği belirlendi. Göz doktorlarının ISBCS yapmamasının ana nedenleri endoftalmi riski (%87,6) ve adli sorunlar (%86,9) idi. Sonuç: Sonuç olarak Türkiye'deki oftalmologların büyük kısmı ISBCS uygulamazken, yaklaşık %20'sinin ISBCS uygulamakta olduğunu saptadık. Bununla birlikte ISBCS için medikolegal kaygılar devam etmektedir. Oftalmologların az bir kısmı hiçbir durumda ISBCS uygulamayacağını ifade ederken, uygun şartların sağlanması hâlinde genel olarak ISBCS'ye karşı olumlu tutum mevcuttur. ISBCS'nin hastaya ve topluma sağlayabileceği avantajlardan uygun hastaların faydalanabilmesi adına ulusal/uluslararası kılavuzlar oluşturulmasına ihtiyaç vardır.

Anahtar Kelimeler: Katarakt; fakoemülsifikasyon; anket
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