Telephone follow-up one day post-cataract surgery

Abstract

Clinical relevance: With the increasing use of technology and an emerging need for virtual clinical reviews, particularly following the recent pandemic, it is essential to evaluate the safety of these clinical tools.

Background: This retrospective study aims to determine the safety of virtual follow-up day one after cataract surgery.

Methods: All patients who underwent cataract surgery at Auckland District Health Board, New Zealand (Aotearoa), and were triaged for telephone review the day after surgery, from 5^th November 2018 to 31^st January 2020, were eligible. Outcomes measured: presentations to the acute eye clinic prior to the post-operative visit (number and reasons) and complications at the one-month follow-up (persistent inflammation, cystoid macular oedema, raised intra-ocular pressure).

Results: Nine hundred and eighty-seven cataract surgeries were triaged for virtual follow-up over the retrospective study period. Nine hundred and eighty-five cases in 928 patients met the inclusion criteria. The median duration of phone calls was 5 minutes (range 2-30). Prior to the one-month post-operative visit, there were 66 presentations to the acute eye clinic, most commonly due to ocular surface irritation (33.3%) and persisting inflammation (25.8%). At the one-month post-operative review, 110 cases (11.2%) had complications; 62 (6.3%) had persisting inflammation, 46 (4.7%) had cystoid macular oedema, and two (0.2%) had raised intraocular pressure.

Conclusions: This is the largest study of a virtual day one post-operative follow-up following cataract surgery, and demonstrates that, in carefully selected subjects, virtual follow-up is a safe alternative to a clinic review. This method could significantly reduce healthcare costs and serve to be more efficient and favourable for patients and clinicians.

Keywords: COVID-19; Cataract; telehealth; virtual.