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Conventional routine clinical review may not be necessary after uncomplicated phacoemulsification
B D Allan1, R M Baer, P Heyworth
1Moorfields Eye Hospital, London.
Aim:
To determine the clinical intervention rate during routine review after uncomplicated phacoemulsification.
Methods:
A review of case notes in 651 consecutive cases of uncomplicated phacoemulsification from 1994 (< or = 5.5 mm self sealing wound) was performed. The intervention rate at scheduled routine review visits and at unscheduled visits to the eye casualty service in the first 120 postoperative days was recorded. Interventions were defined as departures from predetermined postoperative care protocols.
Results:
Clinical interventions were reported in 2.8% (95% confidence interval 1.5 to 4.1%) of (n = 1652) routine follow up visits. Many of these interventions were avoidable or trivial; 90% of patients had no postoperative intervention at any visit. 7.3% of patients made unscheduled visits to the emergency service. The intervention rate in this group was 50% (35.9 to 64.1%).
Conclusions:
The intervention rate in routine clinical review after uncomplicated modern cataract surgery is low. Alternatives to conventional postoperative review, including shared care with non-ophthalmologists and improved perioperative patient education with an open channel for self referral, should be evaluated.
