Incidence of unplanned visits after cataract surgery in two large cohorts with different anti-inflammatory treatment protocols.

Abstract

To compare incidences and reasons for unplanned extra visits after phacoemulsification surgery in two unselected clinical populations with different postoperative treatment protocols. Retrospective cohort study. We reviewed medical records of 1000 patients that underwent cataract surgery at two adjacent clinics in Sweden. At each clinic, 500 consecutive surgeries were included. Preoperatively recorded comorbidities were registered. One clinic used a non-steroidal anti-inflammatory drug (NSAID) in combination with steroids as postoperative treatment, the other used steroids in monotherapy. Main outcome was the number of patients that returned within 6months after surgery for at least one unplanned visit. Reasons for unplanned visits were secondary outcomes. Among patients receiving combined treatment 84 cases (16.8%) returned for at least 1 extra visit, compared with 63 cases (12.6%) in the group treated with steroids only (RR=1.33 [95% CI 0.99-1.80, p=0.061]). No significant differences were found regarding any underlying reasons for the visits, including cystoid macular oedema (CME). We found increased risks for CME in patients with diabetes mellitus (RR=3.83 [95% CI 1.18-12.41, p=0.016]) and patients with epiretinal membrane (ERM) (RR=10.76 [95% CI 3.14-36.89, p < 0.0001]). Postoperative anti-inflammatory treatment with NSAID in combination with steroids did not reduce need for unplanned postoperative visits or incidence of visually disturbing CME after cataract surgery compared with steroids alone. Patient groups with elevated risks for CME are of interest in future research regarding benefits and optimal use of NSAID treatment after cataract surgery.