Abstract
Background and Objectives: to evaluate whether a set of questions after a routine cataract surgery can predict unexpected findings and avoid an unnecessary follow-up visit. Materials and Methods: single-center, prospective, cohort study included 177 routine cataract surgery cases of two experienced surgeons between November 2019 and December 2020. Inclusion criteria included unremarkable postoperative day one follow-up examination. A set of seven questions regarding complaints with positive or negative answers was presented at the second follow-up visit (PV2)—one week (mean 8.34 ± 1.73 days) after the surgery. The outcome measures were the incidence of unexpected management changes (UMCs) at the PV2 visit (change or addition from a prescribed postoperative drop plan, extra procedures, an urgent referral to an ophthalmologist) and UMCs associations with the answers to a question set. Results: 81.4% of patients had no complaints about postoperative ocular status and answered with negative answers, 18.6% reported one or more complaint (positive answer): dissatisfaction with postoperative visual acuity (6.2%, 11 cases), eye pain (4.0%, 7 cases), increase in floaters after the surgery (4.0%, 7 cases), red eye (4.0%, 7 cases) and others. The prevalence of UMCs at PV2 was 1.7% (3 cases), of which 0.6% (1 case) was the prolonged antibiotic prescription due to conjunctivitis, 0.6% (1 case) was the addition of IOP lowering medication and 0.6% (1 case) was additional medication due to uveitis management. None of the complaints (positive answers) at PV2 were associated with the incidence of UMCs (p > 0.05). Conclusions: there were no associations of UMCs determined with positive answers to the questions. The prediction of UMCs incidence based on the positive answers was not obtained. Thus, we cannot exclude the necessity of a postoperative week one follow-up visit.
Highlights
Cataracts are the leading cause of blindness affecting about 20 million people and remain an important socioeconomic and public health care problem worldwide with surgery as the only effective treatment, and the standard procedure being phacoemulsification with intraocular lens implantation [1,2,3,4,5,6,7,8,9,10,11].Cataract surgery is a common day case procedure worldwide, performed 4.5 million times in 2016 on patients with cataracts in European Union member states [12]
Out of 182 routine cataract surgery cases analysed at the postoperative day one followup visit (PV1), 177 cases (97.25%) were included in the statistical analysis
In 81.4% of cases, patients had no complaints about postoperative ocular status and gave only negative answers at PV2-second follow-up visit (PV2). 18.6% reported one or more complaints: dissatisfaction with postoperative visual acuity—11 cases (6.2%), eye pain— 7 cases (4.0%), increase in floaters after the surgery—7 cases (4.0%), red eye—7 cases (4.0%)
Summary
Cataracts are the leading cause of blindness affecting about 20 million people and remain an important socioeconomic and public health care problem worldwide with surgery as the only effective treatment, and the standard procedure being phacoemulsification with intraocular lens implantation [1,2,3,4,5,6,7,8,9,10,11].Cataract surgery is a common day case procedure worldwide, performed 4.5 million times in 2016 on patients with cataracts in European Union member states [12]. The time and number of close postoperative follow-up visits could be adjusted to detect and manage early clinically relevant complications. Such a model can reduce clinical cost, distribute physician time, and improve well-being of the patient assuring recovery after surgery as well as enhance patient satisfaction as well [3,4,5,6,7,8]. A set of seven questions regarding complaints with positive or negative answers was presented at the second follow-up visit (PV2)— one week (mean 8.34 ± 1.73 days) after the surgery. We cannot exclude the necessity of a postoperative week one follow-up visit
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