Remote Monitoring After Cataract Surgery: A Multicentre Randomized Controlled Trial.

We hypothesize that remote post-operative follow-up involving teleconsultations and self-assessments of visual function and health status, could be a valid alternative to face-to-face clinical examinations in selected cataract patient groups. The aim of our study is to investigate the validity, safety and cost-effectiveness of remote cataract surgery follow-up, and to report on the patients’ experiences with remotely self-assessing visual function.

Eye clinics in the Netherlands, Germany and Austria.

Patients planned for cataract surgery on both eyes, without ocular comorbidities, were allocated (1:1) into one of the two study groups: ‘telemonitoring’ or ‘usual care’. Participants in the ‘telemonitoring’ group performed in-home assessments after cataract surgery (remote web-based visual function tests and digital questionnaires on their own devices, delivered via https://easee.online). Participants in the ‘usual care’ group had conventional on-site post-operative consultations. A digital aptitude assessment was obligatory prior to enrollment. Outcome measures included accuracy of the web-based eye exam for assessing visual acuity and refraction, patient-reported outcome measures (visual function and quality of life), and adverse events.

A total of 94 patients were included in the study. Their mean age was 70±7 years. 94% of the enrolled telemonitoring participants were able to complete the web-based visual acuity and refraction self-assessments independently at home. The majority of participants reported positive experiences with the studied web-based test. Distance visual acuity at baseline was 0.28±0.17 logMAR at the clinic and 0.31±0.24 logMAR at home. Post-operative clinical outcome measurements and patient reported outcome measurements were compared.

Remote cataract care is a promising avenue to comply with the increasing stress on the health care system, lest the technology is validated and patients are able and willing to participate. Our randomized controlled trial provides scientific evidence on this unmet need and delivers the necessary insights on (cost)effectiveness of remote follow-up after cataract surgery. The web-based test’s algorithm will be trained and updated based on the collected data.