Replacing the postoperative week 1 visit after routine phacoemulsification with a telephone consult

Area of Science:

• Ophthalmology
• Patient Care Management

Background:

• Routine postoperative care after phacoemulsification surgery typically includes a clinic visit at postoperative week 1 (POW1).
• Assessing the safety and efficacy of alternative follow-up methods is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To evaluate the safety of substituting the standard POW1 clinic visit with a nurse-conducted telephone consultation.
• To determine if this change impacts the incidence of unexpected management changes or adverse outcomes within the first postoperative month.

Main Methods:

• A retrospective observational study analyzed data from 20,475 patients undergoing uncomplicated phacoemulsification surgery between January 2019 and June 2021.
• Patients with an unremarkable postoperative day 1 (POD1) examination underwent a nurse telephone call at POW1, followed by an in-person clinic consultation at postoperative month 1 (POM1).
• Key outcomes included unexpected management changes, unscheduled visits, additional procedures, and postoperative visual acuity.

Main Results:

• Only 2.64% of patients experienced an unexpected management change within POM1.
• The incidence of unscheduled visits was 2.76%, with 0.11% requiring additional surgery, most commonly for retained lens material.
• A small percentage (0.005%) developed endophthalmitis, and 6.22% had visual acuity worse than 6/12, often due to pre-existing conditions.

Conclusions:

• Replacing the POW1 clinic visit with a nurse-led telephone consultation is a safe strategy for patients with uncomplicated phacoemulsification and a normal POD1 assessment.
• This telehealth approach appears effective in identifying potential complications and managing patient care without compromising safety or visual outcomes.