July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Predictors of Non-adherence to Follow-up after Cataract Surgery: Results from the PCIOL Study
Author Affiliations & Notes
  • Giannis A. Moustafa
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Durga S Borkar
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Retinal Service, Wills Eye Hospital, Pennsylvania, United States
  • Emily A. Eton
    Harvard Medical School, Massachusetts, United States
  • Nicole Koulisis
    University of Southern California Roski Eye Institute, Keck School of Medicine, California, United States
  • Carolyn E. Kloek
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Giannis Moustafa, None; Durga Borkar, None; Emily Eton, None; Nicole Koulisis, None; Carolyn Kloek, None
  • Footnotes
    Support  American Society of Cataract and Refractive Surgeons
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 496. doi:
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      Giannis A. Moustafa, Durga S Borkar, Emily A. Eton, Nicole Koulisis, Carolyn E. Kloek; Predictors of Non-adherence to Follow-up after Cataract Surgery: Results from the PCIOL Study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):496.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Nonattendance of patient postoperative appointments is associated with risk for non-detection of disease, decreased clinical efficiency, underutilization of administrative and clinical resources, and revenue loss. We seek to identify factors that predict non-adherence to follow-up after cataract surgery.

Methods : Medical records of patients who underwent cataract extraction with intraocular lens implantation by phacoemulsification at the Comprehensive Ophthalmology Service, Massachusetts Eye and Ear (MEE), between January 1, 2014 to December 31, 2014, were reviewed. Non-adult, second eye cases, and cases on days of heavy snowfall were excluded. The association of missed visits with variables, such as age, gender, race, smoking status, drinking status, insurance type, travel time to the hospital, ocular comorbidities, major medical comorbidities, major mental comorbidities, intraoperative complications, preoperative visual acuity, whether cataract surgery was combined with another ocular procedure (e.g. vitrectomy, glaucoma surgery), and whether a resident or an attending served as primary surgeon was investigated.

Results : Of the 1099 cases identified, 133 (12.1%) had missed at least one postoperative follow-up visit. Three (0.3%), 29 (2.6%), and 113 (10.3%) cases did not attend their postoperative day 1, week 1, and month 1 appointment, respectively. Fourteen (1.3%) cases did not attend more than one appointment. Very old (≥90) and very young (<30) age (adjusted odds ratio [aOR]=8.85 and 47.62, 95% confidence interval [CI]=1.88-41.67 and 4.13-500, as opposed to middle-aged patients, respectively), smoking status (aOR=2.07, 95% CI 1.26-3.40, as opposed to non-smokers), public insurance (aOR=1.50, 95% CI 1.08-2.08, as opposed to commercial insurance), longer travel time to the hospital (aOR=2.85, 95% CI 1.49-5.46, for more than two hours as opposed to less than an hour), absence of ocular comorbidities (aOR=1.68, 95% CI 1.23-2.30), and the presence of major mental comorbidities (aOR=2.56, 95% CI 1.89-3.45) were associated with non-adherence to follow-up in both the univariate and multivariate analysis.

Conclusions : Certain patient-related factors are associated with higher risk of missing follow-up appointments after cataract surgery. Targeted interventions have the capacity to decrease the rate of missed visits in patients that are high-risk for non-adherence.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


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