Post-operative Day Zero Versus Day One Follow-Up for Uncomplicated Cataract Surgery

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Patient Management

Background:

• Cataract surgery is a common procedure with established postoperative care protocols.
• The optimal timing for the first postoperative follow-up visit after uncomplicated cataract surgery remains a topic of discussion.
• Early postoperative assessment is crucial for detecting and managing potential complications.

Purpose of the Study:

• To compare postoperative outcomes and management strategies for uncomplicated cataract surgery between patients seen on postoperative day 0 (POD0) and postoperative day 1 (POD1).
• To evaluate the impact of early versus slightly delayed first postoperative follow-up on visual acuity, intraocular pressure, and the need for interventions.

Main Methods:

• Retrospective cohort study of 665 patients undergoing uncomplicated cataract surgery (CPT code 66984) between December 2018 and March 2020.
• Exclusion criteria included perioperative complications, combined glaucoma surgery, and incomplete follow-up.
• Data collected included visual acuity (VA), intraocular pressure (IOP), and interventions at the first and second postoperative visits.

Main Results:

• No significant differences were observed in intraocular pressure or the rate of interventions between POD0 and POD1 groups.
• Patients seen on POD0 had significantly worse visual acuity compared to those seen on POD1, but this difference resolved by the second postoperative visit.
• The incidence of intraocular pressure spikes and the need for IOP-lowering interventions did not differ significantly between groups, even in patients with glaucoma.

Conclusions:

• Postoperative management and outcomes for uncomplicated cataract surgery are similar whether the first follow-up is on POD0 or POD1.
• While visual acuity is better on POD1, the overall clinical picture and need for intervention do not significantly differ.
• Surgeons may consider offering POD0 visits as an option for patients undergoing uncomplicated cataract surgery, as it does not appear to negatively impact outcomes or management.