Patients who undergo uncomplicated cataract surgery may be able to forego the day-one follow-up without risking their health, according to a new meta-analysis. Researchers from Poland used a literature search to identify 45 studies that included post-op data and found the most common complications after cataract surgery include corneal edema, postoperative uveitis, intraocular pressure (IOP) elevation, cystoid macular edema and posterior capsule opacification. But they also found most of these complications did not require early surgical intervention.
The researchers concluded that the literature does not support the day-one post-op visit. Instead, other forms of follow up such as a nurse-administered telephone questionnaire and seeing patients early if they have complaints may serve patients—and the healthcare system—better, they said in the study.
The surgeon should still reserve decision-making authority regarding the need for a next-day exam, the study authors note, and should give their patients skipping the visit a topical steroid such as prednisolone or dexamethasone. In addition, patients with glaucoma should receive a combination of topical dorzolamide/timolol and brinzolamide postoperatively to help reduce the risk of complications.
The findings come as welcome news not only for providers looking to ease the burden for their cataract patients, but also for the healthcare systems as a whole. One fewer patient visit could lead to reduced healthcare costs and greater efficiency, without posing an increased risk to the patient’s health.
|Grzybowski A, Kanclerz P. Do we need day-1 postoperative follow-up after cataract surgery? Graefes Arch Clin Exp Ophthalmol. December 19, 2018. [Epub ahead of print].|