Eye Surgery During Pregnancy: Safety by Procedure and Trimester

Non-emergency ocular surgery is generally deferred until postpartum. However, certain conditions require timely intervention. Safety depends on procedure, anesthesia, and gestational age.

Generally Safe in 2nd Trimester (14–26 weeks)

• LASIK/PRK: Elective; best postponed. If done, 2nd trimester minimizes teratogenicity risk. Topical anesthetics have negligible systemic absorption.
• Cataract Surgery (Phacoemulsification): Safe if visually significant. Topical/local anesthesia preferred. Avoid systemic sedatives.
• Glaucoma Surgery (Trabeculectomy, Tube Shunt): Indicated if meds fail. Mitomycin C/5-FU use requires caution (teratogenic potential).
• Retinal Detachment Repair: Urgent; scleral buckle or vitrectomy. Gas tamponade requires postoperative positioning; avoid air travel.
• Corneal Transplant (PK/DALK/DSAEK): Low systemic risk; topical steroids postoperatively.

Contraindicated/Deferred

• Elective refractive surgery (1st/3rd trimester).
• Procedures requiring general anesthesia (unless emergent).
• Radiation-based treatments.

Multidisciplinary coordination (ophthalmology, obstetrics, anesthesia) is mandatory.