Domiciliary post-operative assessment following cataract surgery carried out by specialist nurses

To establish whether first day postoperative review by ophthalmic trained nurses following day case cataract surgery is a safe and effective practice.

A prospective study was undertaken of all patients undergoing day case cataract surgery followed by a domiciliary visit in 1996. Principal outcome measures were: (1) incidence of problems diagnosed by the nurses at the first visit, (2) the rate of referral to the hospital for medical review, (3) incidence of problems identified at the first clinic review (10-14 days later), with particular attention paid to any that might be attributed to an event 'missed' by the nurse at the first day, and (4) visual acuity at 3 months, to allow comparison with previously published national outcome measures.

From 281 cases, although nurses identified a problem in 11%, only 4.2% required referral back to medical staff from the domiciliary visit; 2.1% required re-admission over the first 2 weeks. Only one case (0.35%) was found to have a missed pathology; this patient had no long-term adverse outcome. Visual acuity outcomes at 3 months compared favourably with results from the National Cataract Surgery Survey.

Domiciliary visits by ophthalmic trained nurses are a safe alternative to routine hospital review by medical staff.