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Management of patients with herpetic eye disease undergoing cataract surgery in the UK: a survey

Session Details

Session Title: Cataract II

Session Date/Time: Saturday 16/02/2013 | 08:30-11:00

Paper Time: 10:04

Venue: Hall 1

First Author: : R.Karim UK

Co Author(s): :    D. Parmar   E. Sykakis           

Abstract Details


Ocular manifestations of herpes simplex virus are one of the leading infectious causes of corneal blindness in developed countries. Our aim was to gain consensus in the management of patients with herpetic eye disease who were undertaking cataract surgery. The validity of antiviral prophylaxis has not been prospectively studied in patients having cataract surgery. There are no published guidelines for the timing of drug initiation, dosage and duration of treatment. There is only anecdotal evidence to support initiation of prophylaxis treatment prior to cataract surgery.


Whipps Cross University Hospital, London, UK.


A questionnaire was sent to each member of the Royal College of Ophthalmologists (UK) registered as a cornea consultant. Contact details were obtained from the institution and consultants contacted by post. A stamped self address envelope was sent with the questionnaire. Questionnaires could be completed on paper or using an online password protected version. The questionnaire consisted of 25 questions with space for comments. The survey was designed to ascertain clinician’s management of patients with known HSK undergoing cataract surgery. Specific questions regarding pre, peri and post operative treatment were asked. Given the complexity and variation in treatment regimens, opinions regarding treatment were asked at the end of the questionnaire. Percentage preference for specific treatment is tabled in the results section.


The Royal College of Ophthalmologists had 106 consultants registered as corneal surgeons. We received 70 completed questionnaires. The questionnaire consisted of two parts. Part one related to patients not on antiviral prophylaxis and part 2 to those patients on treatment. Results for part one: The majority of consultants agreed that disease stability was required before offering cataract surgery. 62.5% responded they would operate on patients who had quiescent disease for over 3-6 months. The decision for prophylaxis antivirals divided our respondents with 58.8% in favour of starting antiviral treatment. Of those in favour of treatment, 85% responded they would start treatment 7 days pre operatively. Most consultants (72.46%) did not start topical antiviral treatment. In regards to changing topical steroid use post operatively 80.9% of responders replied they would not change there routine regimen. Results for part 2: 10% of consultants would operate on patients with under 3 months quiescent disease, 39.57% between 3-6 months, 19.1 between 6-12 months and 8.8% over 12 months. Oral antiviral treatment was not increased in 80.9% of replies. The results were similar to the part one group where 72.1% of consultants would not change their post operative steroids regimen.


This questionnaire highlights the need for further clinical studies regarding pre, peri and post operative prophylaxis for patients with herpetic eye disease undergoing cataract surgery. Antiviral prophylaxis is common clinical practice with little change in post operative steroid use.

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