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Xiu Ling Tan, Francine Yang, Hon Kiat Wong, Tock Han Lim; Tele-Ophthalmology Research in Post Phacoemulsification Diagnostic Outcomes (TORPEDO) Study - Phase 1 and 2 Results. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5559.
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To evaluate the accuracy of tele-medicine in detecting post-phacoemulsification outcomes and complications at the one-month post-operative visit, as compared to a face-to-face clinical consultation. Phase 1 (validation phase) aims to assess the accuracy of tele-ophthalmology in detecting clinical parameters relevant to a one-month post-phacoemulsification review; while Phase 2 is a pilot trial of a targeted and novel telemedicine workflow (TeleOph) specifically designed for a one-month post-phacoemulsification consultation.
In phase 1, 80 patients who had undergone phacoemulsification surgery were recruited. This consisted of 20 patients with corneal pathology post-phacoemulsification, 20 with anterior chamber inflammation, 20 with intraocular lens or posterior capsule-related pathology and 20 controls. Anterior segment photography was performed. In phase 2, a prospective study of 30 patients who underwent uneventful phacoemulsification surgery was conducted. At the one-month post-operative visit, patients underwent the TeleOph work-flow which included refraction, intraocular pressure measurement, and slit-lamp and fundus photography. In both phases, images were then read by a masked investigator and compared against the clinical findings of a face-to-face consultation conducted at the same visit.
In Phase 1, anterior segment photography detected corneal pathology with a sensitivity and specificity of 100%; anterior chamber inflammation with a sensitivity of 100% and specificity of 95% and the presence of intraocular lens or posterior capsule-related pathology with a sensitivity of 95% and specificity of 85%. In Phase 2, TeleOph detected corneal and wound-related complications with a sensitivity and specificity of 100%; anterior chamber inflammation with a sensitivity of 75% and specificity of 92.3% and the presence of posterior capsular opacification with a sensitivity of 100% and specificity of 96.6%.
Tele-medicine detects post-phacoemulsification outcomes and complications with a high level of sensitivity and specificity. It best detects corneal and intraocular lens-related complications; with a lower sensitivity and specificity in detecting anterior chamber inflammation.
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