Phacoemulsification cataract surgery: is routine review necessary on the first post-operative day?

To determine the value of routine review on the first post-operative day following phacoemulsification cataract surgery.

A prospective study was performed of 238 consecutive patients who underwent phacoemulsification cataract surgery. Local anaesthesia was used for 97% of patients and surgery was performed as a day-case procedure for 93% of patients. The findings at the first day post-operative review were analysed separately for patients who had undergone uncomplicated surgery and patients who had suffered an intraoperative complication. Four patients were excluded because of incomplete data collection.

A total of 227 patients underwent uncomplicated phacoemulsification cataract surgery. Thirteen (5.7%, 95% confidence interval (CI) 3.1-9.6%) of these were found to have post-operative complications at their first day review which comprised corneal oedema (4.4%, 95% CI 2.1-8.0%), raised intraocular pressure > or = 30 mmHg (1.3%, 95% CI 0.3-3.8%), hyphaema (0.9%, 95% CI 0.1-3.1%), corneal abrasion (0.4%, 95% CI 0.0-2.4%) and anterior uveitis (0.4%, 95% CI 0.0-2.4%). These findings led to the standard post-operative management being altered for 5 (2.2%) patients. Intraoperative complications occurred in 7 (2.9%) patients during phacoemulsification cataract surgery. Five (71%) of these patients had post-operative complications at their first day review.

Routine review on the first post-operative day following uncomplicated phacoemulsification cataract surgery could safely be withdrawn. A single post-operative review at 1-2 weeks after surgery would then be required, supplemented by patient-initiated post-operative review in the interim.