Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2025; 13(1): 94284
Published online Jan 6, 2025. doi: 10.12998/wjcc.v13.i1.94284
Practice patterns among ophthalmic surgeons in treating concomitant oculoplastic conditions in preoperative period: A questionnaire-based study
Bijnya Birajita Panda, Chitaranjan Mishra, Bhagabat Nayak, Avik Kumar Roy, Logesh Balakrishnan, Priyadarshini Mishra
Bijnya Birajita Panda, Bhagabat Nayak, Priyadarshini Mishra, Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar 751019, Odisha, India
Chitaranjan Mishra, Department of Vitreo-Retina, Trilochan Netralaya, Sambalpur 768004, India
Avik Kumar Roy, Department of Glaucoma Services, LV Prasad Eye Institute, Bhubaneswar 751013, India
Logesh Balakrishnan, Department of Statistics, Apollo Hospitals, Chennai 823104, India
Author contributions: Panda BB and Mishra C conceived and designed the study; Panda BB, Mishra C, and Roy AK collected the data; Nayak B and Mishra P contributed data; Panda BB wrote the paper; Balakrishnan L performed the statistical analysis; Mishra C, Nayak B, and Roy AK critically analyzed the paper.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of AIIMS, Bhubaneswar, approval number T/IM-NF/Ophthal/23/33, dated July 26, 2023.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All responses from the participants of the study have been recorded in Excel table format and can be provided upon request to the corresponding author at bigyan_panda@yahoo.co.in.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bijnya Birajita Panda, Assistant Professor, Department of Ophthalmology, All India Institute of Medical Sciences, Sijua, Bhubaneswar 751019, Odisha, India. bigyan_panda@yahoo.co.in
Received: March 14, 2024
Revised: October 2, 2024
Accepted: October 20, 2024
Published online: January 6, 2025
Processing time: 237 Days and 11.5 Hours
Abstract
BACKGROUND

Addressing oculoplastic conditions in the preoperative period ensures both the safety and functional success of any ophthalmic procedure. Some oculoplastic conditions, like nasolacrimal duct obstruction, have been extensively studied, whereas others, like eyelid malposition and thyroid eye disease, have received minimal or no research.

AIM

To investigate the current practice patterns among ophthalmologists while treating concomitant oculoplastic conditions before any subspecialty ophthalmic intervention.

METHODS

A cross-sectional survey was disseminated among ophthalmologists all over India. The survey included questions related to pre-operative evaluation, anaesthetic and surgical techniques preferred, post-operative care, the use of adjunctive therapies, and patient follow-up patterns.

RESULTS

A total of 180 ophthalmologists responded to the survey. Most practitioners (89%) felt that the ROPLAS test was sufficient during pre-operative evaluation before any subspecialty surgery was advised. The most common surgical techniques employed were lacrimal drainage procedures (Dacryocystorhinostomy) (63.3%), eyelid malposition repair (36.9%), and ptosis repair (58.7%). Post-operatively, 47.7 % of respondents emphasized that at least a 4-week gap should be maintained after lacrimal drainage procedures and eyelid surgeries. Sixty-seven percent of ophthalmologists felt that topical anaesthetic procedures should be preferred while performing ocular surgeries in thyroid eye disease patients.

CONCLUSION

Approximately 50% of ophthalmologists handle prevalent oculoplastic issues themselves, seeking the expertise of an oculoplastic surgeon under particular conditions. Many ophthalmologists still favor using ROPLAS as a preliminary screening method before proceeding with cataract surgery. Eyelid conditions and thyroid eye disease are not as commonly addressed before subspecialty procedures compared to issues like nasolacrimal duct obstruction and periocular infections.

Keywords: Oculoplasty; Ophthalmic plastic surgery; Nasolacrimal duct obstruction; Practice patterns; Survey

Core Tip: The study among Indian ophthalmologists reveals reliance on ROPLAS test for preoperative evaluation. Lacrimal drainage procedures dominate surgical interventions, with postoperative care emphasizing a 4-week gap. Topical anaesthesia is preferred for thyroid eye disease surgeries. While many manage oculoplastic issues independently, collaboration with oculoplastic surgeons occurs in complex cases. Nasolacrimal duct obstruction and periocular infections receive more attention compared to eyelid malpositions and thyroid eye disease preoperatively. The findings underscore the importance of comprehensive evaluation and highlight potential areas for practice improvement, including enhancing evaluation methods for less studied conditions and promoting interdisciplinary collaboration for optimal patient care.