Resource management of cataract patients: Can visual rehabilitation be achieved in three visits?

Purpose: To assess the feasibility and acceptability of reduced postoperative follow-up after phacoemulsification using a scleral tunnel technique. Setting: Cataract service of a large free-standing eye hospital in a capital city. Methods: In this pilot study, patients with age-related cataract requiring surgery were prospectively recruited to a standardized management protocol, the three-episode model, with assessment by an independent observer. Main outcome measures were number of postoperative visits, patient satisfaction, and refractive error at 2 and 6 weeks postoperatively. Results: Almost 90% of patients could be managed within this model of care. Patient satisfaction was high; no patient requested further hospital visits. Mean change in refractive error between 2 and 6 weeks was 0.34 diopters (D), with a modal value of 0 D. Patients were able to obtain spectacles 2 weeks postoperatively because little change in refraction occurs over the next month. Conclusion: The three-episode model for the management of patients with cataract could result in significant financial savings. Such savings could be used to treat patients with cataract who otherwise would not have treatment or would have their surgery delayed.