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Durga S Borkar, Emily Gross, Tave A van Zyl, sherleen chen, Carolyn Kloek; Utility of the Postoperative Week 1 Examination and Postoperative Month 1 Dilated Examination after Cataract Surgery: A Pilot Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5576.
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© ARVO (1962-2015); The Authors (2016-present)
There is currently no preferred practice pattern for postoperative evaluation after cataract surgery. The purpose of this retrospective, observational study is to assess the utility of the postoperative week 1(POW1) examination and postoperative month 1(POM1) dilated examination in the perioperative management of patients undergoing cataract surgery.
Cases of cataract extraction by phacoemulsification performed by a single surgeon on the Comprehensive Ophthalmology Service at an academic practice in Boston, MA between 1/1/14 and 12/31/14 were reviewed. Detailed perioperative information was collected. Patients without significant intraoperative complications and a normal postoperative day 1(POD1) examination were included in the final data analysis. Data from the POW1 exam was reviewed to evaluate for a change in management from the initial plan on POD1. Additionally, the results of the dilated fundus examination performed at POM1 were reviewed.
150 cases were reviewed. Of these, 15 patients were excluded. 5 patients had planned combined cataract extraction with pars plana vitrectomy, and 10 patients did not have both a POW1 and POM1 examination. The study population of 135 patients consisted of 83 women and 52 men ranging from 39 to 97 years old. In this population, 26 patients (19%) did not have a normal POD1 examination. This was most commonly due to elevated intraocular pressure in the operative eye. In the remaining 109 patients, the exam was as expected for POD1, and the surgeon’s standard steroid, NSAID, and antibiotic drop regimen was prescribed. At POW1, only 2 of these 109 patients had a change in postoperative management. Both of these patients had a retinal detachment associated with symptoms that prompted the patient to be seen prior to the scheduled POW1 visit. Similarly, at POM1, the dilated fundus exam revealed a new retinal finding in 1 asymptomatic patient. However, since this patient had a trace epiretinal membrane in the operative eye with a best-corrected visual acuity of 20/20, this did not change postoperative management.
The results of this study suggest that the POW1 examination does not change postoperative management after cataract surgery in asymptomatic patients with a normal POD1 examination. Similarly, dilation at POM1 did not reveal any significant unexpected findings in asymptomatic patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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