Zemaitiene Reda, Pasiskeviciute Ieva, Varoniukaite Aiste, Pajeda Pijus, Grzybowski Andrzej, Zaliuniene Dalia
Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, 44037 Kaunas, Lithuania.
Department of Ophthalmology, University of Warmia and Mazury, 10719 Olsztyn, Poland.
Medicina (Kaunas). 2021 Oct 22;57(11):1144. doi: 10.3390/medicina57111144.
to evaluate whether a set of questions after a routine cataract surgery can predict unexpected findings and avoid an unnecessary follow-up visit. single-center, prospective, cohort study included 177 routine cataract surgery cases of two experienced surgeons between November 2019 and December 2020. Inclusion criteria included unremarkable postoperative day one follow-up examination. A set of seven questions regarding complaints with positive or negative answers was presented at the second follow-up visit (PV2)-one week (mean 8.34 ± 1.73 days) after the surgery. The outcome measures were the incidence of unexpected management changes (UMCs) at the PV2 visit (change or addition from a prescribed postoperative drop plan, extra procedures, an urgent referral to an ophthalmologist) and UMCs associations with the answers to a question set. 81.4% of patients had no complaints about postoperative ocular status and answered with negative answers, 18.6% reported one or more complaint (positive answer): dissatisfaction with postoperative visual acuity (6.2%, 11 cases), eye pain (4.0%, 7 cases), increase in floaters after the surgery (4.0%, 7 cases), red eye (4.0%, 7 cases) and others. The prevalence of UMCs at PV2 was 1.7% (3 cases), of which 0.6% (1 case) was the prolonged antibiotic prescription due to conjunctivitis, 0.6% (1 case) was the addition of IOP lowering medication and 0.6% (1 case) was additional medication due to uveitis management. None of the complaints (positive answers) at PV2 were associated with the incidence of UMCs ( > 0.05). there were no associations of UMCs determined with positive answers to the questions. The prediction of UMCs incidence based on the positive answers was not obtained. Thus, we cannot exclude the necessity of a postoperative week one follow-up visit.
评估常规白内障手术后的一组问题能否预测意外情况并避免不必要的随访。单中心、前瞻性队列研究纳入了2019年11月至2020年12月期间两位经验丰富的外科医生进行的177例常规白内障手术病例。纳入标准包括术后第一天随访检查无异常。在第二次随访（PV2）时，即在手术后一周（平均8.34±1.73天）提出了一组关于有肯定或否定答案的主诉的七个问题。观察指标为PV2随访时意外管理变更（UMC）的发生率（术后规定滴眼液方案的变更或增加、额外手术、紧急转诊至眼科医生）以及UMC与一组问题答案的关联。81.4%的患者对术后眼部状况无主诉且回答为否定，18.6%报告了一项或多项主诉（肯定答案）：对术后视力不满意（6.2%，11例）、眼痛（4.0%，7例）、术后飞蚊症增加（4.0%，7例）、眼红（4.0%，7例）及其他。PV2时UMC的发生率为1.7%（3例），其中0.6%（1例）是因结膜炎延长抗生素处方，0.6%（1例）是增加降眼压药物，0.6%（1例）是因葡萄膜炎治疗增加药物。PV2时的所有主诉（肯定答案）均与UMC的发生率无关（P>0.05）。UMC的发生与对问题的肯定答案无关联。未根据肯定答案得出UMC发生率的预测结果。因此，我们不能排除术后一周随访的必要性。
