Utility, safety, and accessibility of phone call follow-up in strabismus surgery postoperative care

Strabismus surgery follow-up is used to identify postoperative complications and assess surgical outcomes. Traditionally, follow-ups at our center required in-person postoperative week 1 (POW1) visits. Common obstacles to completing clinic visits include work conflicts and transportation challenges. The purpose of this study was to investigate the safety, cost-effectiveness, and potential for improving healthcare access of phone call follow-ups instead of in-person follow-ups at POW1.

We retrospectively reviewed data from 370 consecutive strabismus surgery patients between mid-2018 and 2021. Successful POW1 follow-up was defined as an attended in-person visit or completion of a standardized phone questionnaire.

Of 188 scheduled in-person POW1 visits, 179 were successful. Of the 182 scheduled phone POW1 follow-ups, 175 were successful (95.2 vs 96.2% successes [P = 0.66]). Of 148 POW1 in-person visits with another follow-up within 6 months, 9 complications were identified. Of 150 POW1 phone follow-ups with another follow-up within 6 months, 7 complications were identified. There were no missed complications noted at postoperative month 3. No complications resulted in vision loss. The phone follow-up group traveled an average distance of 70.0 miles; the in-person group, 45.9 miles. Overall, 44.1% of patients had to travel >50 miles for their postoperative visits.

In our study cohort, POW1 phone call follow-ups after strabismus surgery maintained patient engagement and had equivalent rates of complication detection to in-person follow-up. Implementing phone calls for early follow-up has the potential to improve healthcare accessibility for patients who travel long distances.