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Telephone follow-up for routine cataract surgery: a change in practice in response to the COVID-19 pandemic
First Author: I. Rafiq UK
Co Author(s): R. Yardy T. Cochrane M. Elalfy
COVID-19 pandemic introduced pressures across the health service, including the need to minimise patient footfall in hospitals and local optometry practices. Cataract surgery is the most commonly performed operation in the NHS, with post-operative care representing a significant workload. The Royal College of Ophthalmologists recent guidance on ﾓRestarting and Redesigning cataract pathways in response to the COVID 19 pandemicﾔ recommends considering telephone follow-up for uncomplicated cataract surgery therefore it was trialled at Maidstone and Tunbridge Wells NHS Trust when surgery restarted after the first wave of the pandemic.
Ophthalmology Department at Maidstone and Tunbridge Wells NHS Trust.
Patients with no ocular co-morbidities who underwent uncomplicated cataract surgery between July to October 2020 were listed for telephone follow-up by the operating surgeon at the time of surgery. A telephone consultation follow-up was conducted by a member of a team of optometrists, nurses and a doctor. If the patient had any concerns which could not be addressed or alleviated over the telephone, the operating surgeon was informed and/or a face-to-face appointment arranged for the patient, as necessary.
A total of 130 eyes of 125 patients were scheduled for telephone consultation follow-up over 113 days from July to October 2020. Out of 130 episodes, 126 were successfully contacted for telephone follow-up. Those who did not answer were contacted on multiple occasions, booked for clinic follow-up, or received written communication of our attempts. Follow-up intervals ranged between 8 to 57 days post-operatively. Concerns were reported in (12/126) 9.5% of episodes, leading to 6 face-to-face assessment requests. Analysis demonstrated 50% of those referred for face-to-face review were not appropriate for this method of follow-up due to ocular co-morbidities.
Telephone consultation is a safe and effective method of follow-up after routine cataract surgery in patients without any ocular co-morbidities. It is important to ensure appropriate patient selection as those with co-morbidities are more likely to experience concerns and benefit from a face-to-face review. In addition, patients with hearing difficulties, language barriers, or cognitive difficulties are not appropriate candidates for telephone follow-up for cataract surgery as nuances in the post-operative recovery must be clearly relayed.
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