Postoperative follow-up optimization in cataract surgery

Postoperative follow-up is an important element of the system for ensuring the safety and satisfaction of cataract patients. Existing approaches to the regulation of follow-up time do not allow to fully implement the strategy of early detection of postoperative complications, which requires the search for new solutions and complex evaluation of their effectiveness.

Purpose: to improve the safety of cataract surgery by optimizing the postoperative follow-up.

Materials and methods. A comparative cohort study in 2 groups of patients undergoing cataract surgery included 1951 patients in the main group and 2436 patients in the control group. In the control group of patients, the examination was scheduled within the terms regulated by the clinical recommendations on the 1st, 7rd, 28th day after the intervention. In the main group of patients, the second visit was scheduled on the 3rd day after surgery. The main outcome for assessing the efficacy of the follow-up regimens was the early detection of postoperative complications. Additional efficacy criteria were the visual acuity values after cataract phacoemulsification compared to the control group.

Results. Clinical and functional outcomes in both groups did not differ with respect to visual acuity and intraocular pressure parameters before and after surgery (p > 0.05), demonstrating the achievement of a best corrected visual acuity (BCVA) of 0.9 ± 0.2 at 7 days after surgery. A visit at 3 days postoperatively significantly increased the probability of early detection of acute postoperative endophthalmitis (p = 0.018). As a result of endophthalmitis treatment, patients in the main group had an BCVA ³ 0.3, patients in the control group £ 0.2.

Conclusions. Optimization of the monitoring regime of patients after surgery includes shifting the examination period from 7 to 3 days after the procedure, which provides a statistically significant reduction of the risks of late diagnosis (more than 1 day after manifestation) and improves the results of acute postoperative endophthalmitis treatment, thus increasing the safety of cataract surgery.

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