Abstract
Purpose :
During the coronavirus (COVID-19) pandemic, reducing unnecessary clinic visits is critical to limit risk of exposure for patients and providers. We hypothesized that final visual outcomes and postoperative complication rates in patients with postoperative week 1 (POW1) telehealth visits would be similar to patients with in-person POW1 visits in this retrospective cohort study.
Methods :
All uncomplicated cataract surgeries performed by senior residents with routine postoperative day 1 (POD1) exams and POW1 telehealth visits conducted from July 1, 2020 to December 31, 2020 at a single academic institution were reviewed. Controls were drawn from uncomplicated surgeries performed by senior residents with in-office POW1 visits during the same period the year prior (7/1/19 – 12/31/19). Visual outcomes, including final corrected distance visual acuity (CDVA) and deviation of manifest refraction from the target refraction, were compared between the two groups, along with rates of significant postoperative complications.
Results :
Thirty-eight patients (51 eyes) with POW1 telehealth visits and 44 patients (57 eyes) with POW1 in-office visits were included in the study. There were no statistically significant differences in baseline demographics or preoperative CDVA and biometry measurements between the two groups. The average final postoperative month 1 (POM1) logMAR CDVA was 0.030 and 0.021 (p=0.284) in the telehealth and in-office groups, respectively, with 44 (86%) telehealth eyes and 51 (90%) in-office eyes within 0.50 D of the target refraction (p=0.610). Six eyes (12%) in the telehealth group and 3 eyes (5%) in the in-office group developed complications noted at the POM1 visit (p=0.222), comprised of pseudophakic cystoid macular edema (CME) or mild persistent/recurrent postoperative iritis. In all instances, the CME and iritis resolved with topical steroids and/or NSAIDs, with final CDVA 20/30 or better.
Conclusions :
There was no statistically significant difference in final CDVA, refractive outcomes, or postoperative complication rates in eyes undergoing POW1 telehealth as compared to in-office visits. In uncomplicated cataract surgeries, POW1 telehealth visits can be a safe and effective alternative to in-office visits to minimize exposure risks during the COVID-19 pandemic.
This is a 2021 ARVO Annual Meeting abstract.