Can the postoperative follow-up visit be deferred up to four weeks after an uneventful cataract surgery? - A randomized controlled trial

Abstract

Purpose: The aim of this study was to compare the postoperative visual outcome after a Day 0 examination in patients with two follow-ups, one between Day 3 to Day 7 and other between Day 25 to Day 30 to those with a single ophthalmic follow-up directly after 25–30 Days and to assess the safety of deferral of the first follow-up visit at 1 week. Methods: Randomized Controlled Trial was conducted at a tertiary eye care hospital, with 848 patients enrolled for the study. Patients meeting the inclusion criteria were selected. Their pre-operative and post-operative data was collected and the patients were divided into groups based on the type of cataract surgery and the postoperative follow-up protocol through randomization. Results: No significant difference was observed in the postoperative visual outcome in patients that underwent postoperative review at Day 3–7 and Day 25–30 as opposed to those that followed up directly at Day 25–30 after a mandatory Day 0 examination for all patients. Conclusion: In patients with no preexisting ocular or systemic comorbidity undergoing an uneventful cataract surgery, the postoperative follow-up visit can be safely deferred until 4 weeks, without any impact on the postoperative visual outcome, thereby conserving the available resources which can be deviated towards better eye care services.

Evaluation of the Corneal Endothelium Following Cataract Surgery in Diabetic and Non-Diabetic Patients

“…A single surgeon performed all surgeries, while with multiple surgeons we would probably have had a wider palette of postoperative results. Another limitation was the short-term follow-up of the study groups, although several studies showed that 4 weeks after uneventful cataract surgery is enough time for follow-ups, as the visual outcome at the end of 1 month is optimal and the postoperative complications usually occur in the first 2 weeks [ 48 , 49 ].…”

Deferring Postoperative Follow‑Up Visits up to 4 Weeks After Uneventful Cataract Surgery in a Tertiary Level Eye Hospital: Protocol for a Prospective, Quantitative, Experimental Control Study

“…Sample size is calculated as follows: 2[Zα + Z1 -β] 2 × (sd2/d2) = 2 [1.96 + 1.645 ] 2 × [(0.1125)2/(0.025)2] = 263 for one group, where reference mean values for postoperative visual outcomes are taken from the study conducted by Deshpande et al [25]. The number of participants in intervention group will be 263 and the number of participants in the control (reference) group will be 263.…”

“…Meltzer et al [24] performed a study using data from the PRECOG (Prospective Review of Early Cataract Outcomes and Grading) trial and reported that visual acuity immediately after cataract surgery was highly correlated with visual acuity after 40 days, suggesting that for the purposes of quality assessment, follow-up of all patients is not needed. A study by Deshpande et al [25] concluded that visual outcomes after uneventful cataract surgery were comparable between patients followed up on days 3 to 7 and days 25 to 30 in comparison to patients directly followed up on days 25 to 30. Additionally, it was observed that the first follow-up visit could be safely deferred until 4 weeks after uneventful cataract surgery, including phacoemulsification or small-incision cataract surgery (SICS), in patients with no preexisting ocular or systemic comorbidity [25].…”

“…A study by Deshpande et al [25] concluded that visual outcomes after uneventful cataract surgery were comparable between patients followed up on days 3 to 7 and days 25 to 30 in comparison to patients directly followed up on days 25 to 30. Additionally, it was observed that the first follow-up visit could be safely deferred until 4 weeks after uneventful cataract surgery, including phacoemulsification or small-incision cataract surgery (SICS), in patients with no preexisting ocular or systemic comorbidity [25]. The purpose of this study is to evaluate, from a safety perspective, altering the standard postoperative management guidelines after cataract surgery so that the first follow-up visit at 1 week is deferred in patients with no significant preexisting ocular or systemic comorbidity and no intraoperative surgical complications or immediate postoperative complications at the time of discharge from the hospital.…”