Phacoemulsification cataract surgery: is routine review necessary on the first post-operative day?

Purpose To determine the value of routine review on the first post-operativ e day following phacoemulsification cataract surgery. Methods A prospective study was performed of 238 consecutive patients who u nderwent phacoemulsification cataract surgery. Local anaesthesia was used f or 97% of patients and surgery was performed as a day-case procedure for 93 % of patients. The findings at the first day post-operative review were ana lysed separately for patients who had undergone uncomplicated surgery and p atients who had suffered an intraoperative complication. Four patients were excluded because of incomplete data collection. Results A total of 227 patients underwent uncomplicated phacoemulsification cataract surgery. Thirteen (5.7%, 95% confidence interval (CI) 3.1-9.6%) o f these were found to have post-operative complications at their first day review which comprised corneal oedema (4.4%, 95% CI 2.1-8.0%), raised intra ocular pressure greater than or equal to 30 mmHg (1.3%, 95% CI 0.3-3.8%), h yphaema (0.9%, 95% CI 0.1-3.1%), corneal abrasion (0.4%, 95% CI 0.0-2.4%) a nd anterior uveitis (0.4%, 95% CI 0.0-2.4%). These findings led to the stan dard post-operative management being altered for 5 (2.2%) patients. Intraop erative complications occurred in 7 (2.9%) patients during phacoemulsificat ion cataract surgery. Five (71%) of these patients had post-operative compl ications at their first day review. Conclusions Routine review on the first postoperative day following uncompl icated phacoemulsification cataract surgery could safely be withdrawn. A si ngle post-operative review at 1-2 weeks after surgery would then be require d, supplemented by patient-initiated post-operative review in the interim.