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Priscilla Nobrega, Karine Bojikian, Philip P Chen; Number of postoperative follow-up visits after phacoemulsification in glaucoma and nonglaucoma patients. Invest. Ophthalmol. Vis. Sci. 2018;59(9):482.
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To evaluate the number of postoperative (PO) follow-up visits in the first 90 days after standard phacoemulsification for patients with and without glaucoma, and to examine factors associated with more visits.
Review of all patients who underwent phacoemulsification as a sole procedure by a single surgeon between 2007 and 2016 at the University of Washington. Data collected included pre-, intra-, and postoperative findings, and number of postoperative visits in the 90 days after surgery. When both eyes of one patient were eligible, the eye undergoing surgery first was chosen. The patients were divided into 2 groups: normal eyes (NG) and open angle glaucoma without prior incisional glaucoma surgery (GL). GL patients were categorized using ICD-10 glaucoma staging definitions. IOP spike was defined as an increase ≥50% of the baseline IOP. Univariate analysis was performed using the 2-tailed t-test for continuous variables and Fisher’s exact test for categorical variables.
593 eyes were included (NG=458; GL=135). GL patients were significantly older (Table 1) and needed more postop visits than NG patients in the first 90 days after surgery (3.7 ± 1.3 vs. 3.2 ± 0.7; p<0.001). GL distribution by disease severity for the 110 patients with reliable preop visual fields was: mild glaucoma (N=26, 3.5 ± 0.8 visits, 39% with >3 visits), moderate (N=41, 3.8 ± 1.5 visits, 39% with >3 visits) and severe (N=43, 4.0 ± 1.6 visits, 47% with >3 visits). 19% of NG had >3 visits. Moderate and severe GL had significantly more visits than NG (p=0.017, p=0.002, respectively), but not mild GL (p=0.058). In NG, patients with more postop visits were younger (p<0.001). In GL, patients with higher preop IOP (p=0.017), intraop iris stretching (p=0.009) and PO day 1 IOP spike (p=0.020) needed more postop visits (Table 2).
Glaucoma patients required more postoperative visits than normals. For GL, need for more visits increased with glaucoma severity, and 4 or more postop visits were needed about twice as often as for NG. Pre-, intra-, and early postoperative factors may predict which GL patients will need more follow-up appointments in the first 90 days after phacoemulsifcation.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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