Westborg Inger, Mönestam Eva
Department of Clinical Sciences/Ophthalmology, Faculty of Medicine, Umeå University, Umeå S-901 85, Sweden.
Clin Ophthalmol. 2020 Jul 1;14:1847-1854. doi: 10.2147/OPTH.S246195. eCollection 2020.
To evaluate the number of postoperative visits after cataract surgery in two institutions with different routines.
A population-based prospective, observational, cohort study was conducted at two institutions in northern Sweden. All cataract surgery cases during a 1-year period were included. The study group was 1249 cases, who followed the standard routine at the Sunderby clinic, ie, no planned postoperative visit for patients without comorbidity who had uncomplicated surgery. All cases (n=1162) having surgery during the same 1-year period at the Umeå clinic were selected as the control group. The routine in Umeå was a planned postoperative visit for all patients after first eye surgery, and on second eye surgery patients with other ocular comorbidity.
A postoperative visit was planned in 44% (555/1249) of the study group and in 83% of all control group cases (966/1162). Significantly less patients in the study group (9% vs 16%; p=0.000036) initiated an unplanned contact. Patients with a distance to the hospital of 70 km or longer were less inclined to seek unplanned care (p=0.016). There was no difference in postoperative outcomes between the patients who initiated contact and those who did not in the study and control hospitals.
Without compromising patient safety, it is possible to reduce the burden of postoperative visits in cases with uncomplicated cataract surgery. A reduction in the number of visits is obtained only if the standard routine is no planned postoperative visits in uncomplicated cases without ocular comorbidity for both first and second eye surgery.
评估两家采用不同常规流程的机构中白内障手术后的复诊次数。
在瑞典北部的两家机构开展了一项基于人群的前瞻性观察队列研究。纳入了1年期间内所有的白内障手术病例。研究组为1249例，他们遵循松德比诊所的标准流程，即对于无合并症且手术无并发症的患者不安排计划内的术后复诊。将同期在于默奥诊所进行手术的所有病例（n = 1162）选为对照组。于默奥的常规流程是对所有接受第一眼手术的患者以及接受第二眼手术且有其他眼部合并症的患者安排计划内的术后复诊。
研究组中44%（555/1249）的患者安排了术后复诊，对照组所有病例中有83%（966/1162）安排了术后复诊。研究组中发起非计划内联系的患者明显更少（9% 对16%；p = 0.000036）。距离医院70公里或更远的患者寻求非计划内医疗护理的倾向更低（p = 0.016）。在研究医院和对照医院中，发起联系的患者与未发起联系的患者术后结果没有差异。
在不影响患者安全的情况下，对于无并发症的白内障手术病例，有可能减轻术后复诊的负担。只有当标准流程是对于无眼部合并症的无并发症的第一眼和第二眼手术病例均不安排计划内的术后复诊时，才能减少复诊次数。
