Complications of phacoemulsification on the first postoperative day: Can follow-up be safely changed?

Purpose: To establish the rate of complications detected on the first posto perative day and therefore the need for evaluation on that day. Setting: Hinchingbrooke Hospital, Huntingdon, England. Methods: Complications detected on the first day after phacoemulsification cataract surgery were retrospectively reviewed over 8 months. Ophthalmic nu rse practitioners performed the 1 day postoperative examination and kept a log of patients seen, recording complications detected and whether referral to a physician was required. All patients had had routine phacoemulsificat ion with intraocular lens implantation without anterior vitrectomy or trabe culectomy, as identified from the log book and cross-checked with operating theater records. Notes were reviewed if a complication or referral was rec orded. Most cases were performed under local anesthesia,as day cases using a temporal corneal approach. Sections were routinely left unsutured unless enlarged or closure was not satisfactory at the conclusion of surgery. Results: The review yielded 392 patients. Six (1.53%) had intraocular press ure (greater than or equal to 30 mm Hg) requiring treatment, 1 (0.26%) had painless iris prolapse, 11 (2.81%) had corneal abrasions, and 7 (1.78%) wer e given a more intensive steroid regime. No cases of fibrinous uveitis were recorded. Conclusions: Potentially sight-threatening complications present on the fir st postoperative day, albeit infrequently. With our current practice and ca se mix,the need for this review persists. It is possible to reduce the dema nd on physician time by using appropriately trained nonmedical practitioner s. J Cataract Refract Surg 1999; 25:985-988 (C) ASCRS and ESCRS.