Bass E B, Sharkey P D, Luthra R, Schein O D, Javitt J C, Tielsch J M, Steinberg E P
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md, USA.
Arch Ophthalmol. 1996 Sep;114(9):1121-7. doi: 10.1001/archopht.1996.01100140323012.
To assess the frequency and content of post-operative examinations by ophthalmologists and optometrists for cataract surgery patients without operative complications and to assess the referral patterns of optometrists when complications are identified.
In 1992 we conducted a survey of randomly selected members of the American Academy of Ophthalmology and American Optometric Association. Responses were obtained from 538 (82%) of 655 eligible ophthalmologists and 130 (84%) of 154 eligible optometrists.
Eighty-eight percent of responding ophthalmologists reported that patients had 4 or more visits within 4 months after surgery, 97% of ophthalmologists performed the first postoperative examination on their cataract surgery patients, and 60% of ophthalmologists reported that no other eye professional saw their patients postoperatively. Forty-six percent of responding optometrists participated in postoperative care of cataract surgery patients, and usually performed their first postoperative examination 7 days after surgery; 78% of these optometrists reported that they saw patients 3 or more times after surgery. Postoperatively, 83% of ophthalmologists and 75% of optometrists usually performed at least 1 dilated fundus examination, 87% of ophthalmologists and 47% of optometrists performed 4 or more slit-lamp examinations, 74% of ophthalmologists and 42% of optometrists performed 4 or more tonometry tests, and 83% of both groups performed 2 or more refractions. More than 80% of responding optometrists involved in postoperative care of cataract surgery patients immediately refer a patient to an ophthalmologist if there is evidence of acute glaucoma or an unexplained decrease in vision in the eye that was operated on. For less urgent complications, most optometrists promptly make a referral to an ophthalmologist.
In 1992, a small percentage of ophthalmologists and optometrists were performing fewer follow-up examinations and tests for cataract patients than recommended by the American Academy of Ophthalmology. Not all optometrists immediately refer to an ophthalmologist any acute complication that they identify postoperatively.
评估眼科医生和验光师对无手术并发症的白内障手术患者进行术后检查的频率和内容，并评估验光师在发现并发症时的转诊模式。
1992年，我们对美国眼科学会和美国验光协会的随机选定成员进行了一项调查。655名符合条件的眼科医生中有538名（82%）回复，154名符合条件的验光师中有130名（84%）回复。
88%的回复眼科医生报告说患者在术后4个月内进行了4次或更多次就诊，97%的眼科医生对其白内障手术患者进行了首次术后检查，60%的眼科医生报告说没有其他眼科专业人员在术后为其患者看病。46%的回复验光师参与了白内障手术患者的术后护理，通常在术后7天进行首次术后检查；这些验光师中有78%报告说他们在术后为患者看诊3次或更多次。术后，83%的眼科医生和75%的验光师通常至少进行1次散瞳眼底检查，87%的眼科医生和47%的验光师进行了4次或更多次裂隙灯检查，74%的眼科医生和42%的验光师进行了4次或更多次眼压测量测试，两组中83%的人进行了2次或更多次验光。参与白内障手术患者术后护理的回复验光师中，超过80%的人如果发现有急性青光眼或手术眼视力不明原因下降的迹象，会立即将患者转诊给眼科医生。对于不太紧急的并发症，大多数验光师会迅速转诊给眼科医生。
1992年，一小部分眼科医生和验光师为白内障患者进行的随访检查和测试比美国眼科学会推荐的要少。并非所有验光师都会将他们术后发现的任何急性并发症立即转诊给眼科医生。
