THE USE OF AOS VIDEO-BASED TELEMEDICINE SOFTWARE FOR CONSULTATIONS AND INTERACTIVE VISUAL ACUITY MEASUREMENT AFTER CATARACT SURGERY

This study assessed the feasibility, safety, accuracy and patient satisfaction in the use of a novel telemedicine software allowing clinician to perform live video consultation, assess images of the anterior eye and to complete an interactive live visual acuity measurement following routine cataract surgery.

Ophthalmology Department, Queen Mary's Hospital, Frognal Avenue, Sidcup DA14 6LT, King's College Hospital NHS Foundation Trust

This prospective cohort study assessed the use of AOS video and visual acuity platform in 65 patients two weeks after routine cataract surgery. We compared this cohort with an equivalent cohort of patients who attended a face to face consultation two weeks after cataract surgery. The remote consultation included a subjective assessment of patient's symptoms and compliance with medications, visual evaluation of the external eye, assessment of photos of the anterior segment obtained with a smart phone and sent via the software, a digital analysis of hypaeremia on photographs supplied by the patient and a remote interactive measurement of ETDRS visual acuity during the consultation.

Patients who selected a video consultation follow up were younger (median 73 years versus 85 years), had better general health conditions and were more familiar with the use of computer and smart phone devices, compared to the patients who selected a clinic review. The video consultation allowed a reliable assessment of symptoms, compliance to medication and examination of the external eye in all cases. 97% of patients were very satisfied with the video assessment, 3% were satisfied with the consultation but experienced some technical difficulties in the connection . 4% of patients seen by video consultation required a clinic review due to intolerance to postoperative medications. There was no adverse effect or missed postoperative complications in the group assessed by video consultation when they were assessed at final clinic review 5 weeks after surgery. 

This study showed that the video consultation was effective, safe, accurate and satisfactory in this cohort of patients following routine cataract surgery. There were no adverse effects/complications missed in the group subject to video consultation at two weeks versus the patients reviewed in clinic at two weeks. The novel process of integrating remote video consultation to routine medical care resulted in a favourable feedback from patients and offered the additional benefit of reduced hospital attendances and travelling expenses for patients.