Community optometrist-led post-operative cataract care: how many patients re-present to the hospital ophthalmic department?

Abstract

Background: Cataract surgery represents a significant workload for ophthalmologists in Ireland. Post-operative shared care with community optometrists can reduce the need for hospital follow-up appointments. Aims: Eight years after the introduction of a shared-care pathway, we wished to quantify the proportion of patients discharged to the community for post-operative follow-up, and the number that re-present to the hospital due to cataract-related issues. Methods: We collected data on all patients who underwent cataract surgery in our centre over a three month period. Electronic patient records were used to establish whether the patient was discharged on the day of surgery, and whether they re-attended the department post-operatively. Post-operative complications were recorded. Results: 394 cataract procedures were carried out over the three months. 369 patients were discharged to an optometrist for their post-operative care. Of those, 38 were re-referred or re-presented to the hospital ophthalmic service. 21 of these had a post-operative complication. Complications included seven cases of post-operative uveitis, 5 patients with cystoid macular oedema, one retinal detachment and one retained lens fragment. Conclusions: Community optometrist-led post-operative care for uncomplicated patients is an effective way of reducing the workload associated with cataract surgery. Re-referral pathways must be in place to facilitate timely management of post-operative complications.