Purpose:

1. Comparison Of Cataract Outcomes When The Initial Postoperative Evaluation Is Performed On Postoperative Day # 0 Versus Postoperative Day # 1Stephen A. Blatt, MD1,2, Jay I. Perlman, MD, PhD1,2, Evan B. Stubbs, Jr., PhD1,2,3Department of Ophthalmology, Loyola University Medical Center, Maywood, IL1Ophthalmology Section/Surgery Service, Edward Hines Jr. VA Hospital, Hines, IL2Research Service, Edward Hines Jr. VA Hospital, Hines, IL3 Patient Characteristics (cont.): Comparison of Outcome Data: Introduction: Post-Op Day # 0 Group Cataract cases analyzed in this study included only those performed by the most experienced surgeons (i.e. senior residents and attendings), and done under monitored anaesthesia care with topical anaesthesia. One patient from each group had an intraoperative posterior capsular tear with anterior vitrectomy and sulcus intraocular lens placement. All patients were found to be Seidel negative at every post-op visit. By convention, the follow-up regimen for patients undergoing cataract surgery is at one day, one week and one month. At Hines VA Eye Clinic, in an attempt to maximize convenience for the patient and minimize travel burden, we have given patients the option of having the initial postoperative evaluation on the same day of surgery. Post-Op Day # 1 Group Purpose: The purpose of this study is to assess differences in cataract outcomes between same-day versus one-day postoperative visits for initial evaluations. Results: • At initial evaluation: For post-op day # 0 patients: Pre-op VA was 20/50.6 (0.395 ± 0.198); Post-op VA was 20/102.0 (0.196 ± 0.162); Pre-op IOP was 15.6 ± 2.8 mm Hg; Post-op IOP was 29.6 ± 11.1 mm Hg; KE was 1.36 ± 0.78; and ACI was 1.61 ± 0.68. . For post-op day # 1 patients: Pre-op VA was 20/32.1 (0.624 ± 0.895); Post-op VA was 20/38.4 (0.521 ± 0.266); Pre-op IOP was 16.1 ± 2.3 ; Post-op IOP 21.1 ± 7.7 ; KE was 0.61 ± 0.73; and ACI was 1.61 ± 0.56. • At one week post-op:For post-op day # 0 patients, VA was 20/32.8 (0.610 ± 0.298); IOP was 14.7 ± 3.6; KE 0.46 ± 0.57; and ACI was 0.85 ± 0.77. For post-op day # 1 patients, VA was 20/28.6 (0.70 ± 0.236); IOP was 16.4 ± 4.3; KE was 0.61 ± 0.62; and ACI was 0.35 ± 0.55. • At one month post-op:For post-op day # 0 patients, VA was 20/30.3 (0.662 ± 0.292); IOP was 14.2 ± 4.7; KE was 0.0 ± 0.0; and ACI was 0.04 ± 0.19. For post-op day # 1 patients, VA was 20/26.9 (0.743 ± 0.251); IOP was 14.7 ± 2.5; KE was 0.0 ± 0.0; and ACI was 0.0 ± 0.0. * Data presented as mean values; see Results section for standard deviations. Methods: A retrospective chart review of 52 patients (26 per study group) examined differences in post-op outcomes among patients for whom the initial post-op exam was performed on the day of surgery (3-7 hours following surgery) versus the day following surgery. The data examined included pre- and post-op visual acuity (VA; 20/20=1.0), pre- and post-op intraocular pressure (IOP), corneal edema (KE; Scale=0-4), and anterior chamber inflammation (ACI; Scale=0-4). The data were collected for the initial visit (post-op day 0 or day 1), as well as at post-op week 1 and month 1 for all patients. • Acknowledgements: • This work was supported by the Department of Veterans Affairs. • Research supported by the Richard A. Perritt Charitable foundation. Patient Characteristics: Conclusions: All patients were male. Patient age ranged from 58 – 88 years in the post-op day # 0 group (72.3 ± 8.9 years), and ranged from 56 – 93 years in the post-op day # 1 group (73.4 ± 9.3 years). The study analyzed cataract cases performed from February 2008 through October 2008. The initial cataract postoperative evaluation can be safely and effectively performed on the day of surgery, rather than on the day following surgery. There was no significant long term difference in patient outcomes using the same day visit as the initial evaluation. Whenever travel burden is an issue for patients undergoing cataract surgery, same day postoperative visits can be safely employed in order to improve patient convenience and satisfaction.