Rethinking Postoperative Follow-Up After Cataract Surgery: A Comparative Analysis Of Clinically Relevant Complications At 24 Versus 72 Hours

To evaluate whether scheduling the first postoperative visit at 72 hours after uncomplicated phacoemulsification allows for more clinically meaningful detection of complications compared with the standard 24-hour assessment.

Ophthalmic Unit of the University Hospital of Verona, Italy.

This retrospective, single-center comparative study included 1,372 eyes operated between July 2023 and November 2025, divided into two cohorts of 686 eyes: a 24-hour and a 72-hour follow-up group. All patients were re-evaluated at 30 ± 10 days (T2). The primary endpoint was the proportion of clinically relevant persistent complications, defined as findings detected at the first visit (T1), treated, and confirmed at T2. Included events were infectious endophthalmitis, persistent corneal edema, persistent ocular hypertension, and significant uveitis. Secondary endpoints included the positive predictive value of T1 findings, frequency of transient findings, emergency department visits within 30 days, and final UDVA, CDVA, and IOP at 30 days.

At T1, corneal edema was more frequent in the 24-hour group than in the 72-hour group (17.2% vs 10.4%; χ², p = 0.00044). Ocular hypertension was also higher at 24 hours (9.8% vs 2.2%; χ², p < 0.001). However, clinically relevant persistent complications at T2 did not differ between groups. Emergency visits within 30 days were rare (1.2% vs 0.7%). No cases of endophthalmitis or significant uveitis occurred. At 30 ± 10 days, final IOP (13.7 ± 2.7 vs 14.5 ± 2.1 mmHg), UDVA, and CDVA were comparable between groups.

Although early postoperative findings were more frequently detected at 24 hours, final visual and pressure outcomes were equivalent between groups. A 72-hour postoperative visit may allow a more clinically meaningful assessment of complications while limiting detection of transient findings, without compromising patient safety.