Br J Ophthalmol 1997;81:548-550 ( July )
Conventional routine clinical review may not be necessary after
uncomplicated phacoemulsification
Bruce D S Allan,
Roger M Baer,
Peter Heyworth,
I Graham M Duguid,
John K G Dart
Moorfields Eye Hospital,
London
Correspondence to: Bruce Allan, Moorfields Eye
Hospital, City Road, London EC1V 2PD.
Accepted for publication 26 March 1997
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 (
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.
© 1997 by British Journal of Ophthalmology