Complications of phacoemulsification on the first postoperative day: Can follow-up be safely changed?

Purpose: To establish the rate of complications detected on the first postoperative day and therefore the need for evaluation on that day. Setting: Hinchingbrooke Hospital, Huntingdon, England. Methods: Complications detected on the first day after phacoemulsification cataract surgery were retrospectively reviewed over 8 months. Ophthalmic nurse practitioners performed the 1 day postoperative examination and kept a log of patients seen, recording complications detected and whether referral to a physician was required. All patients had had routine phacoemulsification with intraocular lens implantation without anterior vitrectomy or trabeculectomy, as identified from the log book and cross-checked with operating theater records. Notes were reviewed if a complication or referral was recorded. Most cases were performed under local anesthesia,as day cases using a temporal corneal approach. Sections were routinely left unsutured unless enlarged or closure was not satisfactory at the conclusion of surgery. Results: The review yielded 392 patients. Six (1.53%) had intraocular pressure (greater than or equal to 30 mm Hg) requiring treatment, 1 (0.26%) had painless iris prolapse, 11 (2.81%) had corneal abrasions, and 7 (1.78%) were given a more intensive steroid regime. No cases of fibrinous uveitis were recorded. Conclusions: Potentially sight-threatening complications present on the first postoperative day, albeit infrequently. With our current practice and case mix,the need for this review persists. It is possible to reduce the demand on physician time by using appropriately trained nonmedical practitioners. J Cataract Refract Surg 1999; 25:985-988 (C) ASCRS and ESCRS.