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T. Fayers, W. Abdullah, J. Koshy, M. R. Wilkins; Unnecessary Avoidance of Safe Post-Operative Activities After Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1054.
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300,000 cataract operations are performed per year in the UK, of which the vast majority are by phacoemulsification and intraocular lens implantation with a sutureless, small-incision, corneal tunnel. Post-operative complications involving wound leak or anterior chamber collapse are rare and are usually related to poor wound construction or trauma. There is no evidence that restricting normal activities of daily living (ADLs) following routine cataract surgery reduces the frequency of these complications. We became aware that many patients were unnecessarily restricting ADLs post-operatively and we investigated the extent of this and tested interventions designed to improve post-operative activity.
Three groups of 50 patients answered a questionnaire after routine first-eye cataract surgery. They were asked if they had avoided certain ADLs, namely bending, face washing, hair washing, cooking, cleaning, exercising, watching TV and gardening in the 3 weeks between surgery and review. If they had avoided activity enquiry was made into why they were doing so. The first group (standard) received standard discharge instructions telling them that they could continue all ADLs. The second group (written) received an additional written sheet specifying that the tested ADLs were all safe. The third group (photo) received a sheet with photographs of people performing safe ADLs.
64% of standard patients reported avoiding one or more of the ADLs. The figures for the written and photo groups were 44% (p=0.07 chi squared) and 30% (p=0.0013) respectively.The ADLs that were avoided are summarised in table 1In all groups more than 50% of patients reported that they had avoided activities on their own volition (not because they had been advised not to).
A large percentage of patients unnecessarily avoid safe ADLs after cataract surgery. Giving patient a written sheet did not significantly improve this figure. Providing patients with a photo sheet significantly reduced the number of patients avoiding safe activities.
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