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Darren Hill, John Conklin, Eric Higgins; The utility of activity restrictions following cataract surgery. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4800.
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To evaluate whether patient compliance with given activity restrictions yields a lower incidence of post-operative complications. This study also explores patient compliance with post-operative instructions as well as the secondary costs of post-operative restrictions in terms of patient stress and time taken off of work.
This is a prospective, single-center study. A convenience sample was obtained from patients presenting to the ophthalmology clinic for their week one appointment following cataract surgery by one of two surgeons from 11/2/2017-12/1/2017. Patients who elected to participate were given a 13-question survey, which inquired about restricted and other activities in which the patient engaged in the first post-operative week. It also included questions about stress experienced and modifications to or time taken off of work due to the restrictions. The patient chart was reviewed for any documented post-operative complications.
Of the 29 surveys completed, 27 (93%) reported engaging in restricted activities in the first post-operative week. Including all patients, 86% bent over, 62% lifted >10 pounds, 52% showered the face, 38% rubbed the operated eye, and 28% strained (Valsalva). In regard to non-restricted activities, 59% of patients exercised, 79% sneezed, 66% coughed, and 17% vomited. 43% of patients experienced a degree of stress with 18% experiencing moderate stress. 28% of patients took off work due to the activity restrictions (158 work-hours total, average 19.75 work hours per person). No post-operative complications were discovered in any of the patients.
Despite acknowledged limitations including small sample size, recall bias, and limited number of surgeons, this study demonstrates that a large portion of patients engage in commonly restricted activities post-operatively, and none in our sample experienced post-operative complications. However, in many patients the restrictions led to increased stress and decreased societal productivity. While activity restrictions may be indicated in certain situations (intraoperative complications, high-risk occupations, etc.), restrictions following cataract surgery may not provide significant benefit in reducing post-operative complications. There is need for a large multicenter sample to validate outcome comparisons due to the low incidence of complications following cataract surgery.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Patient activities in the first post-operative week.
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