An Audit Investigating the Usefulness of a Hospital-Based 4-Week First Postoperative Review Following Routine Cataract Surgery

Abstract

Aim: Timing of postoperative review after routine phacoemulsification cataract surgery in the English National Health Service is not specified in the Royal College of Ophthalmologists Cataract Surgery Guidelines. There are wide variations in when the first postoperative review occurs in routine practice. This audit assesses the usefulness of a 4-week first postoperative review in the hospital setting, in the context of high volume routine cataract surgery. Setting: Manchester Royal Eye Hospital cataract treatment centre based at Withington Hospital, UK. Methods: Retrospective review of 200 consecutive sets of case notes of patients undergoing routine phacoemulsification cataract surgery with standard 4-week postoperative review using a proforma. Results: 88% of patients were discharged at the 4-week review for this episode. 4.5% of patients required earlier unplanned review. 16.5% of patients experienced a postoperative problem, anterior uveitis was the commonest complication. 15% of patients were referred from the postoperative clinic for investigation or continuing management of co-existing ocular disease. Conclusions: A four-week hospital-based first post-operative review following routine cataract surgery does not serve the purpose of treating sight-threatening complications. A substantial proportion of routine cataract surgery patients (88%) were discharged at this review. A routine 4-week follow-up review may therefore not be required within a hospital setting in many cases. It would be a reasonably safe option to consider early discharge of such patients to an accredited community optometrist for routine postoperative review and refraction in the presence of careful patient selection and good access to emergency eye care facilities.