ePoster

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Title:

Can same day review be safely used in place of next day review following uneventful cataract surgery?

Poster Details

First Author: A. Richey USA

Co Author(s):    J. Tenewitz   J. Kera   M. Cartwright              

Abstract Details

Purpose:

As technology for cataract surgery has evolved, so too has the delivery of postoperative care. In the recent past, surgeons have evaluated their patients at one day, one week, and one month postoperatively. More recently, many surgeons have altered their postoperative schedule to either eliminate the next day review (NDR) or move it to the same day as surgery. Evaluation at one day is aimed at the detection and management of postoperative complications such as IOP elevation, uveitis, wound leakage, or corneal abrasion/edema. The present study evaluates the efficacy of same day review (SDR) as a viable replacement for NDR.

Setting:

Data was collected from patients at Medical Eye Associates, a private practice Ophthalmology clinic in Kissimmee, Florida. The study was carried out in conjunction with the University of Central Florida College of Medicine.

Methods:

A retrospective review of data from 135 eyes that underwent uneventful phacoemulsification with intraocular lens implantation and received an optometrist-led SDR was carried out to evaluate the utility of the SDR. Patient data was collected from January 01, 2018 to December 31, 2018. Exclusion criteria included: (i) age less than 18 (ii) intraoperative complications (iii) concomitant ocular surgery (iv) ocular comorbidities. Data collected regarding SDR postoperative complications, frequency of interventions, and visual outcomes were compared to NDR data published in the literature.

Results:

Preoperative IOP was 13.6 mmHg (95%CI 13.0-14.2) while SDR IOP was 14.9 mmHg (95%CI 13.6-16.2) (p < 0.05). There was no difference in IOP preoperatively and postoperatively at 1 week (p=0.58) or 1 month (p=0.20). Six eyes (4.44%) were treated at the SDR for IOP?30, one eye (0.7%) was a glaucoma suspect and was treated for an IOP of 23. There was one case each (0.7%) of iritis, corneal edema, vitreous prolapse, and cortex retention that were treated. All complications resolved with treatment and there were zero emergency visits. Postoperative LogMAR BCVA was 0.15 (95%CI 0.11-0.19) at 1 month.

Conclusions:

Next day review (NDR) is costly to the healthcare system as it takes up clinic time and puts an additional burden on patients. When comparing our SDR results with published literature from NDR studies, we found no significant differences in postoperative complication rates or visual outcomes. SDRs after uneventful surgery did not miss any adverse complications that may have been identified at the NDR and visual outcomes were comparable or better with SDR than NDR. Thus, it can be concluded that replacing the next day review with a same day review is appropriate, safe, and efficacious.

Financial Disclosure:

None