Same Day 'See-And-Treat’ Cataract Surgery Has Comparable Cancellation Rates With Traditional Face To Face Cataract Clinics
Published 2025 - 43rd Congress of the ESCRS
Reference: PO265 | Type: Free paper | DOI: 10.82333/xb4r-5b60
Authors: Neofytos Michail* 1 , Anastasia Neokleous 1 , Fedonas Herodotou 2 , Stelios Christodoulou 1 , Dimitris Kola 1 , Georgina Hadjilouka 1 , Sotiria Palioura 3 , Klea Panagidou 4 , Aikaterini Athanasiadou 5
1Ophthalmology Clinic,Archbishop Makarios III Hospital, State Health Services Organization,Nicosia,Cyprus, 2Medical school,University of Cyprus,Nicosia,Cyprus, 3Medical school,University of Cyprus,Nicosia,Cyprus;Ophthalmology Practice,Athens Eye Experts,Athens,Greece;Ophthalmology Clinic,Archbishop Makarios III Hospital, State Health Services Organization,Nicosia,Cyprus, 4Health Sciences,European University Cyprus,Nicosia,Cyprus, 5Ophthalmology Practice,Athens Eye Experts,Athens,Greece
Purpose
Cataract surgery backlogs post-COVID-19 have provided impetus to develop novel pathways to improve service efficiency. The Nightingale Centre of Excellence for Eyes (CEE) in Exeter, UK has operated three different cataract pathways: traditional face-to-face (F2F) assessments, virtual pre-assessment (VPA), and ‘See-and-treat’ (S&T). Cancellations remain a significant barrier to streamlined cataract services, posing large inconveniences and accruing avoidable costs for patients and healthcare providers. Thus, assessing the differences in cancellation rates between novel and existing pathways is crucial. This study compares these pathways through analysis of cancellation rates, cancellation reasons, and post-operative complications.
Setting
Nightingale Hospital, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
Methods
Retrospective analysis conducted on cataract surgery patients at the Nightingale CEE, Exeter, of the Royal Devon University Healthcare NHS Foundation Trust, UK, between September 2022 and June 2023. Electronic health records were accessed to extract the following data for analysis: cancellation rates, cancellation reasons, post-operative complications. Statistical comparisons between pathways regarding cancellation reasons and complications were performed using Fisher’s exact tests. Statistical significance was set at p <0.05.
Results
A total of 667 patients were included. 284 (42%), 160 (24%), and 223 (33%) were under VPA, F2F, and S&T respectively. 31 (4.6%) operations were cancelled. Cancellation rates in VPA, F2F and S&T were 1.4%, 6.9%, and 7.1% respectively. S&T patients were more likely to be cancelled due to other ocular pathology compared to VPA patients (p=0.016) and F2F patients had a higher chance of cancelling due to unsafe medical status (p=0.0058) compared to both other pathways. Complications were seen in 5.4% of cases, mostly anterior uveitis (n=6), corneal oedema (n=6), cystoid macular oedema (n=5), and dry eye (n=5). A higher chance of dry eye in F2F patients compared to VPA patients (p=0.04623) was seen. No sight-threatening cases were observed.
Conclusions
Our findings showcase the feasibility of high-throughput cataract surgery pathways. The virtual pre-assessment pathway led to the lowest cancellation rates. A notable finding of interest was that despite significant differences in set-up, the 'See-and-treat' cancellation rate was extremely similar to that of the traditional pathway (7.1% vs 6.9%). Such findings suggest the viability of 'See-and-treat' to boost surgical productivity and reduce inconveniences, without a significant increase in cancellation risk. Further studies should be performed to explore the long-term implications of such novel pathways and build on our proposed strategies to further minimise cancellation rates and uphold efficient cataract care.