Inger Westborg1, Eva Mönestam2. 1. From the Department of Clinical Sciences/Ophthalmology, Faculty of Medicine, Umeå University, Umeå, Sweden. Electronic address: inger.westborg@telia.com. 2. From the Department of Clinical Sciences/Ophthalmology, Faculty of Medicine, Umeå University, Umeå, Sweden.
Abstract
PURPOSE: To evaluate safety perspectives when the standard routine after cataract surgery is no planned postoperative visit. SETTING: Eye Clinic, Sunderby Hospital, Luleå, Norrbotten County, Sweden. DESIGN: Prospective case series. METHODS: All cataract surgery cases during a 1-year period were included. The study group had the standard routine at the clinic, that is, no planned postoperative visit for patients without comorbidity and uneventful surgery. For the control group, patients who had surgery during 1 month of the 1-year period were chosen. All these patients had a planned postoperative visit. All surgeons involved were experienced. The outcome measures were any planned postoperative visit, any complication and/or adverse event, postoperative corrected distance visual acuity (CDVA), and any postoperative control/contact initiated by the patient. RESULTS: The study comprised 1249 patients (1115 in the study group and 134 in the control group). No significant differences in demographics, postoperative CDVA, frequency of planned visits because of ocular comorbidity, or postoperative patient-initiated contacts were found between the 2 groups. Of the 1249 patients, 9% (117 patients) initiated a postoperative contact, of whom 26% (30 patients) also had a scheduled visit. The reasons for the patient-initiated contacts were visual disturbance, redness and/or chafing, pain, and anxiety. An evaluation of all medical records 2 years postoperatively found no reports of missed adverse events. CONCLUSIONS: It was possible to refrain from planned postoperative visits for patients having uncomplicated cataract surgery. However, preoperatively, patients with comorbidities should be provided with individual planning of their postoperative follow-up. Preoperative counseling is important, and the clinic must have resources to answer questions from patients and be prepared for additional unplanned postoperative visits.
PURPOSE: To evaluate safety perspectives when the standard routine after cataract surgery is no planned postoperative visit. SETTING: Eye Clinic, Sunderby Hospital, Luleå, Norrbotten County, Sweden. DESIGN: Prospective case series. METHODS: All cataract surgery cases during a 1-year period were included. The study group had the standard routine at the clinic, that is, no planned postoperative visit for patients without comorbidity and uneventful surgery. For the control group, patients who had surgery during 1 month of the 1-year period were chosen. All these patients had a planned postoperative visit. All surgeons involved were experienced. The outcome measures were any planned postoperative visit, any complication and/or adverse event, postoperative corrected distance visual acuity (CDVA), and any postoperative control/contact initiated by the patient. RESULTS: The study comprised 1249 patients (1115 in the study group and 134 in the control group). No significant differences in demographics, postoperative CDVA, frequency of planned visits because of ocular comorbidity, or postoperative patient-initiated contacts were found between the 2 groups. Of the 1249 patients, 9% (117 patients) initiated a postoperative contact, of whom 26% (30 patients) also had a scheduled visit. The reasons for the patient-initiated contacts were visual disturbance, redness and/or chafing, pain, and anxiety. An evaluation of all medical records 2 years postoperatively found no reports of missed adverse events. CONCLUSIONS: It was possible to refrain from planned postoperative visits for patients having uncomplicated cataract surgery. However, preoperatively, patients with comorbidities should be provided with individual planning of their postoperative follow-up. Preoperative counseling is important, and the clinic must have resources to answer questions from patients and be prepared for additional unplanned postoperative visits.
Authors: Giannis A Moustafa; Durga S Borkar; Sheila Borboli-Gerogiannis; Scott H Greenstein; Alice C Lorch; Ryan A Vasan; Carolyn E Kloek Journal: PLoS One Date: 2019-09-19 Impact factor: 3.240