Moderator
Mark A. Kontos, MD, ABO
Panelists
Richard Tipperman, MD
Ken D. Novak, MD, ABO
Viewing Papers
Expand a paper title to the right to view the paper abstract and authors. Use the video link to jump to that poster in the session.
Presenting Author
Sean J. McCafferty, MD, MS, FACS
Purpose
Evaluate multi-mode fluidics control comparison of two leading phacoemulsification platforms with differing methodologies for fluidics control: Active pressurized versus gravity-pump assisted
Methods
Prospective, randomized, contralateral crossover comparative study. Fifteen (15) patients randomized first eye to either gravity pump assited (WhiteStar Signature Pro) or Active Fluidics (Centurion) phaco platform. Contralateral eye was completed with the alternate machine for a total of 30 study eyes. An anterior chamber intracameral pressure transducer was placed to record real-time intraocular pressures at 25 hz. Single surgeon standardized flow rate, aspiration rate, effective bottle height and phaco power setting were fluidic control optimized for the respective phacoemulsification unit.
Results
Intraocular pressure (IOP) variation as measured by root mean square (RMS) from mean IOP was significantly higher with the gravity pump assisted fluidics control (2.30+/-1.27) compared to the active fluidics control (1.84+/-1.05), p=0.01. IOP variation was also measured by number of deviations per paired case from mean IOP greater than +/-10 mm Hg was significantly higher with the gravity pump assisted (641+/-108) compared to the active fluidics (503+/-97), p=0.033. Endothelial cell count loss and post operative corneal edema and inflammation at 90 days were statistically equivalent in both systems respectively (p=0.63).
Conclusion
Gravity pump assisted fluidics control appears to have significantly larger fluidic control variation than active fluidics control whether measured by deviation from mean IOP measured by RMS or a set peak value in the phacoemulsification modes. The methodology can be used to evaluate potential design changes in fluidic control.
Presenting Author
Nick Mamalis, MD
Co-Authors
Melissa Yao MD, Shwetha Mudalegundi BSc, Kevin Eid MSc, MD, Neil Kelkar MD, Nour Bundogji MD, Liliana Werner PhD, MD
Purpose
To identify trends in toxic anterior segment syndrome (TASS) over a ten year period of time
Methods
TASS questionnaires on instrument cleaning and reprocessing and products used during cataract surgery between 2012, and 2022 were retrospectively analyzed to identify common practices that could cause TASS. Comparisons were drawn with previous analysis on data from 2007-2012. Additional data from 2023 questionnaires will be added to the analysis.
Results
Data from 77 questionnaires submitted by surgery centers were analyzed. During this timeframe there was a mean of 53 cases of TASS per year, in comparison to a mean of 473 TASS cases per year from 2007-2012. There was a 52% decrease in improper handpiece flushing technique, 33% decrease in the intraoperative incidence of occluded irrigation/aspiration tips, 37% decrease in the reuse of phaco tubing, 23% decrease in the use of enzymatic cleaners, 96% increase in the use of intracameral antibiotics after surgery.
Conclusion
The number of TASS outbreaks have decreased substantially over the last decade and is most likely due to widespread adoption of proper cleaning practices for surgical instruments, in addition to the adoption of appropriate practices in the use of intracamerally injected products.
Presenting Author
Everardo Hernandez Quintela, MD, MSc, FACS, FACS
Co-Authors
Laura Drew-Bear MD, Divya Srikumaran MD, Ashley Behrens MD
Purpose
To evaluate the percentage of time a surgeon focuses on the surgical field during cataract surgeries conducted with the aid of a 3-dimensional visualization system (HUVS, NGENUITY 3D, Alcon, USA) incorporating DataFusion technology, various other factors were also examined.
Methods
This comprehensive investigation involved a single-arm, descriptive cross-sectional study, wherein two surgeons completed 100 cataract surgeries while utilizing the NGENUITY 3D system equipped with DataFusion. The data collected include surgeon behavior under scrutiny encompassed eye movements, head positioning, blink rate, the proportion of time dedicated to the surgical field, and DataFusion parameters, as monitored with the Argus Science Eye Tracking glasses (iMotions, Boston, MA). Additionally, the study investigated the percentage of time during which surgeons assumed a slouched posture, as recorded by a wearable feedback device.
Results
The average blink rate was 3.53 blinks per minute (bpm). The phacoemulsification step had the lowest blink rate (1.6 bpm), followed by cortex aspiration (1.8 bpm). The corneal incision had the highest blink rate (5.11 bpm). A decrease in the blink rate was associated with the difficulty of the surgical step. One hundred cataracts were included. Surgeons spent 75% of their surgical time within the surgical field, 1.8% in the Datafusion parameters, and 0.27% in the Centurion display. Surgeons were within 15 degrees of the upright position 85% of the time.
Conclusion
The blink rate decreases as the surgeon focuses on the most demanding surgery step. The visual system prioritizes a stable, uninterrupted target view, thereby reducing the need for blinking, which would momentarily disrupt the image. The HUVS system successfully maintains the surgeon's focus on the surgical field approximately 75% of the time.
Presenting Author
Tauanni Alves, MD
Co-Authors
Jessica V�ras Moura Lanza MD, Newton Kara-Junior MD, PhD, Silvana Rossi MSc, Roberto Pineda MD
Purpose
The OrbiTau Surgical Simulator is a synthetic eye model developed to enhance cataract surgical training. This study describes the perspectives of Harvard Ophthalmology faculty and residents regarding the effectiveness of OrbiTau.
Methods
A cross-sectional study was conducted in which 11 surgeons from the Masschusetts Eye and Ear Infirmary, with prior experience utilizing simulated phacoemulsification platforms, conducted cataract surgery with the OrbiTau and filled out a satisfaction questionnaire based on the Likert scale.
Results
Regarding various OrbiTau components, 90.90% of participants reported that the OrbiTau lens capsule during capsulotomy was comparable to the human; 72.72% found that the consistency of the OrbiTau lens was analogous to that of the human lens nucleus; 63.63% observed that the posterior lens capsule resembled the native posterior capsule one; and 72.72% noted that the red reflex was similar to that of the dilated human pupil. Most participants described the OrbiTau as being easier to use and more realistic than other commercially available surgical eye simulators.
Conclusion
From this survey of the Orbitau Surgical Simulator at a single institution we are encouraged that this model realistically replicates ocular structures and could serve as a viable option for surgical training in cataract surgery.
Presenting Author
Naren Shetty, MS, PhD
Co-Authors
Ronald Yeoh FRCOphth, FRCSEd, Arkasubhra Ghosh PhD
Purpose
This study aimed to identify biomarkers in aqueous samples and anterior capsules and analyze its contribution to the formation of anterior capsular fibrosis.
Methods
In this prospective clinical study, we recruited 96 cataract surgery patients, divided into two groups: 58 with fibrosed capsules and 38 with normal capsules, all aged 40-80 years. Pediatric cases were excluded. Pre-operative assessments included slit-lamp photography and AS-OCT. Pre-operative treatment comprised non-steroidal anti-inflammatory and antibiotic drops, with steroids avoided. During routine cataract surgery, aqueous humor samples were collected for biomarker analysis. Metabolites were extracted and analyzed using UPLC-MS/MS. Statistical analysis was performed using MetaboAnalyst v6.0
Results
Volcano plot fold change analysis revealed 4733 upregulated and 1863 downregulated metabolites in the aqueous humor of fibrosed capsules compared to normal capsules. PLS-DA plot demonstrated clear separation between aqueous humor samples of normal and fibrosed capsules. Discriminant metabolomic features were identified based on the Variable Importance in Projection (VIP) score. Top VIP score metabolites, including 3-Indolepropionic acid, Quipazine, Harmaline, Morphinan-3-ol, Bunitrolol, and Tacedinaline, were upregulated in control samples compared to fibrotic samples. These metabolites are implicated in anti-inflammatory and anti-fibrotic processes.
Conclusion
Fibrosis and inflammation modulating metabolites identified in this study could serve as potential biomarkers for anterior capsular fibrosis. This discovery provides a foundation for developing targeted therapeutic interventions to mitigate fibrosis following cataract surgery.
Presenting Author
Justin Cheong, BSc
Co-Authors
Danielle Trief MD, MSc
Purpose
The prevalence of cataracts and the demand for cataract surgery are expected to rise in the United States as the population ages. This study aims to quantify patient demand for cataract surgery and the concentration of cataract and refractive surgeons on a state-by-state basis to identify potential areas of unmet need.
Methods
Google Trends data from 2023 were collected retrospectively to determine the relative search volumes (RSV) for the term �cataract surgery� by state. The American Society of Cataract and Refractive Surgery (ASCRS) member directory was used to identify practicing cataract and refractive surgeons (n=3,256). The surgeon concentration per capita was calculated by dividing the number of included ASCRS members in each state by the state�s population in 2023 as estimated by the U.S. Census Bureau. The surgeon demand index (DI) for each state was calculated by dividing RSV by surgeon concentration per capita.
Results
The RSV for �cataract surgery� on Google increased by 250% from 2004 to 2023. The RSVs in 2023 were highest in Maine (100), West Virginia (100), Pennsylvania (99), and Florida (95) and lowest in Oregon (71), Nevada (64), Colorado (63), and Utah (56). The surgeon densities per 100,000 were highest in Massachusetts (1.9), New Hampshire (1.7), Utah (1.5), and North Dakota (1.4) and lowest in Nevada (0.6), Kentucky (0.6), Mississippi (0.5), and Alaska (0.4). The DIs were highest in Alaska (181), Mississippi (165), Montana (149), and Kentucky (143) and lowest in North Dakota (54), New Hampshire (53), Massachusetts (43), and Utah (38).
Conclusion
The results reveal disparities in the distribution of cataract and refractive surgeons across the United States and highlight states with a relative undersupply compared to demand (e.g. Alaska and Mississippi). As cataract surgery demand increases, these data may help guide targeted interventions to address gaps in eye care.
Presenting Author
Mark C. Lobanoff, MD, ABO
Purpose
Can technology be used to reduce IOL calculation errors, wrong patient/wrong lens errors, and decrease complications during cataract surgery? A new cloud-based surgical planning platform, that also monitors activity in the operating room, was used for 12 months to establish an answer.
Methods
This is an observational study that was carried out over 12 months in a private practice cataract clinic and OR setting. 4 anecdotal cases will be presented whereby the software technology improved the visual outcome for a patient or averted a complication.
Results
In one instance, the software prevented a wrong power toric IOL from being calculated. In the second case, it prevented an inadvertent wrong IOL from being implanted in a patient. Two additional cases will be reviewed in which the software improved the surgical outcome of the procedure by averting a surgical complication.
Conclusion
New technology released in 2024 can make immediate and lasting improvements in patient and surgical safety during cataract surgery.
Presenting Author
Khaled A Elbassiouny, PhD, MRCSEd
Purpose
To present a case of late capsular block syndrome presented 2 years after uneventful cataract surgery Setting: Case presented at outpatient clinic of Alexandria Ophthalmology Hospital and the operation performed under local sedation at the operating room, Alexandria ophthalmology hospital, Alexandria, Egypt.
Methods
A 67-year-old male presented with diminution of vision in his left eye months after uneventful cataract surgery. On examination his left eye visual acuity was 6/60. The left eye was pseudophakic with posterior chamber IOL in capsular bag with presence of whitish milky material filling the lower half of the capsular bag between the IOL and the posterior capsule obscuring part of the pupillary area, the cornea was clear and the anterior chamber shows no cells or flare, IOP was 18 mm Hg. Combined A and B-Scan ultrasound of the posterior segment was unremarkable. sample was obtained from milky material intaoperatively and sent for culture. The treatment was completed with irrigation aspiration.
Results
The culture was positive for propionibacterium acne. Postoperative care was done as usual similar to cataract surgery. 2nd day postoperatively media was clear vision improved to 6/12 and patient was satisfied. We followed up the pateinet for 6 month, no postoperative complications detected.
Conclusion
Late capsular block syndrome is a rare complications that may result in drop of vision months or even years after uneventful cataract surgery, P. acne may be associated with the condition however it is usually not associated with inflammation or an infectious process.
Presenting Author
Joshua L. Bierbrier, BEng, MSE
Co-Authors
Christine Law FRCSC
Purpose
Existing cataract surgery training protocols for residents rely on qualitative data. This study aims to fill the gap by providing an objective, quantitative assessment of surgical phase difficulty by comparing residents' completion times with those of staff surgeons to enhance training effectiveness.
Methods
We conducted a retrospective observational study analyzing video recordings of 218 uncomplicated cataract surgeries (112 resident, 106 staff) from Kingston Hospitals. The amount of time spent in each of 15 phases was manually collected for all videos. Phase completion times were compared between residents and staff using one-sided Welch�s T tests (?=0.05) with Holm-Sidak correction. Phase difficulty was quantified using two metrics: Cohen�s d and percentage difference in median phase times. Data processing and analysis was conducted in Python. Ethics approval was not required.
Results
Welch�s T test corrected for multiple comparisons identified eight phases with significant differences in completion times between residents (R) and staff (S): P<0.01 for="" viscoelastic="" injection,="" wound="" creation;=""><0.05 for="" lens="" positioning,="" viscoelastic="" removal;=""><0.0001 for="" capsulorhexis="" (cr),="" hydrodissection="" (hd),="" phacoemulsification="" (pe),="" and="" hydration.="" average="" surgery="" completion="" times="" also="" differed="" significantly=""><0.0001; r:973s,="" s:612s).="" cr="" (84.65%;="" r:106s,="" s:57s),="" pe="" (69.75%;="" r:459s,="" s:270s),="" and="" hd="" (68.08%;="" r:43s,="" s:26s)="" were="" the="" most="" difficult="" based="" percentage="" increase="" in="" median="" phase="" times.="" cohen�s="" d="" effect="" size="" ranked="" pe="" (1.41),="" cr="" (1.28),="" and="" hd="" (0.92)="" as="" most="">
Conclusion
CR, PE, and HD were identified as the most challenging phases for residents, corroborating previous subjective analyses. These quantitative findings can inform evidence-based training protocols and optimize operating time allocation for residents. The results also offer quantitative metrics for future technical research.
Presenting Author
Liwei Ma, MD, PhD
Purpose
To explore the mechanism of monofocal pseudophakic accomodation(PPA) and its correlative factors
Methods
Design: prospective observational case series. 61 cases of cataract patients who had monofacal intraocular lens(IOLs) implanted were enrolled.Preoperative data, including age, IOL model, spherical equivalent(SE),axial length(AL),cornea curvature(K),were collected.At 3 months postoperatively,the PPA was measured by defocus methods.And the correlative factors, such as the uncorrected and corrected distant vision acuity(UCDA,CDVA), the uncorrected and corrected near vision acuity(UCNA,CNDA) at 40cm,cornea astigmatism,pupil size,high order aberration(HOA), IOL movement after medication myosis, were recorded.Pearson corelation analysis and stepwise linear regression analysis were conducted.
Results
At 3 months postoperatively, PPA was 1.25D(1.0 1.75)D. The decimal UCVA(distant/near):1.0(0.8 1.0)/0.40(0.4 0.5)?CVA(distant/near):1.0(0.8 1.0)/0.32(0.32 0.4)?cornea astigmatism?-0.5(-0.75 -0.25)D?pupil size change(normal-myosis)?1.51�0.39mm?HAO?0.15(0.09 0.21)um?Z3-1?0.03�0.03um?Z3+1?0.02(0.01 0.04)um?Z3-3?0.05(0.03 0.08)um?Z3+3?0.03(0.01 0.06)um?SA?-0.00�0.03um?IOL movement?-0.09�0.08mm.Pearson analysis indicated that the PPA was positively related to pupil size change(r=0.51 P?0.000).Stepwise linear regression analysis indicated that age ,pupilsize change,and AL were correlated with PPA(p?0.05?, while the other factors had no relation with PPA.
Conclusion
Monofocal pseudophakic eye has the ability of accomadation, which offer partial near vision.The PPA amplitude are related to age ,pipul size change and axial length.
Presenting Author
Stephen A. LoBue, MD
Co-Authors
Curtis Martin MD, Brittany DeNaro DO, Wyche Coleman MD, Christopher Shelby MD, Nicolas Zaunbrecher MD
Purpose
To develop a quick, reliable instrument for measuring postoperative subjective outcomes in refractive cataract surgery.
Methods
A prospective study was conducted at Willis-Knighton Eye Institute in Shreveport, Louisiana. Patients included bilateral cataract or clear lens extraction with various intraocular lenses (IOLs). A 10-question survey was performed 1 month postoperatively. The first seven questions are answered on a 1-10 scale where patients were asked to rate their satisfaction with different aspects of vision and overall lens choice. Additionally, three binary (yes/no) questions assessed post-operative outcomes such as glare and halo perception and their impact on daily activities. Internal consistency was evaluated using Cronbach's alpha.
Results
A total of 477 eyes from 240 patients were included involving 234 trifocal (Panoptix), 53 EDOF (Vivity), 88 EDOF monofocal (Tehcnis Eyhance), and 102 monofocal (Alcon Acrysof). Cronbach's alpha (0.785) indicated moderately strong internal consistency, consistent with survey validation. Significant correlations were found between visual acuity and satisfaction ratings for distance (r = 0.256; p < 0.001) and near vision (r = 0.195; p < 0.001). However, quality of near vision (? = 0.188, p < 0.001) and quantity of glasses independence (? = 0.116, p < 0.05) were significant predictors of choosing the same lens again.
Conclusion
The RCSS is a valid, reliable tool for assessing visual outcomes and patient satisfaction in refractive cataract surgery. Overall patient satisfaction and lens selection is strongly associated with improvement in quality of near vision and glasses independence among a variety of IOLs.
Presenting Author
Farnaz Javadian, MD
Co-Authors
Wilma Hopman MA, Davin Johnson MD, FRCSC
Purpose
Intraoperative stress levels and heart rates have been studied in residents performing cataract surgery, with limited data in the literature on heart rates (HR) in staff surgeons. Our study investigates heart rates for staff at our centre at each step of cataract surgery, both when supervising residents and as the primary surgeon operating.
Methods
This is an ethics-approved, single centre, prospective observational clinical outcomes study. A chest-strapped Bluetooth device recorded each surgeon�s HR in beats per minute (bpm) for an entire surgical day. Only uncomplicated surgeries were included. The mean, minimum, and maximum HR for each surgical step were compared among surgeons. Data were obtained for 42 cases from 5 healthy surgeons, 2 female, and 3 male, with 1 to 38 years of experience. Repeated measures ANOVA was used to measure HR over time for each step, independent samples t-tests to compare the HR of the staff surgeon when operating versus observing the resident, and a one-way ANOVA to compare the HR between surgeons.
Results
Irrigation and aspiration had the highest mean HR (83 bpm) and mean change in baseline (5.6 bpm), followed by phacoemulsification with a mean of 82.8 bpm and change in baseline of 5.4 bpm. Heart rate variability was statistically significantly different over time, at p<0.001. there="" was="" also="" a="" statistically="" significant="" difference="" in="" hr="" between="" surgeons=""><0.001), with="" the="" staff="" with="" 1="" year="" of="" experience="" having="" the="" highest="" hr="" over="" time,="" and="" the="" staff="" with="" 20="" years="" of="" experience="" having="" the="" lowest="" hr.="" there="" was="" no="" statistically="" significant="" difference="" in="" hr="" between="" observing="" the="" resident="" physician="" compared="" to="" being="" the="" primary="" surgeon="">
Conclusion
This study demonstrates that certain steps of cataract surgery such as irrigation and aspiration, and phacoemulsification can be associated with an increased HR and thus greater stress levels. This can help determine the impact of stress-reducing measures intra-operatively and emphasize areas where residents may require further training.
Presenting Author
Yonca Asfuro?lu, MD, FEBO
Co-Authors
Emine Esra Karaca MD, Ozlem Evren Kemer MD, Mahmut Asfuroglu FEBO
Purpose
To assess the effect of phacoemulsification on the corneal endothelium and stroma in dense cataracts.
Methods
In this prospective and comparative study, participants were categorized into two groups based on cataract severity: Group 1 had dense cataracts and Group 2 had moderate cataracts. The best visual acuity (VA), endothelial cell density (ECD), hexagonality (HEX), coefficient of variation (CV), anterior chamber volume (ACV), central corneal thickness (CCT), and corneal densitometry (CD) were evaluated before and 1 month after phacoemulsification. The mean cumulative dissipated energy(CDE), total fluid aspirated(TFA), and effective phacoemulsification time(EPT) were recorded.
Results
One hundred and three eyes (group 1, 50 eyes ; group 2, 53 eyes) were included in the study. CDE, TFA, and EPT were significantly higher in group 1 (p = 0.0001). At postoperative 1 month, mean endothelial cell loss was 46.5% in dense cataracts and 28.6% in moderate cataracts (p<0.0001, 1396�609="" cells/mm2="" and="" 1868.7�="" 551.6="" cells/mm2="" respectively).="" the="" changes="" in="" hex="" and="" cct="" were="" significantly="" greater="" in="" dense="" cataracts="" after="" phacoemulsification="" (p="0.008" and="" p="0.0001," respectively).="" the="" change="" in="" hex="" was="" positively="" correlated="" with="" tfa="" in="" group="" 1="" (p="0.03)." despite="" these="" findings,="" there="" were="" no="" significant="" differences="" in="" the="" cd="" values="" between="" the="" two="">
Conclusion
Dense cataracts undergoing phacoemulsification showed endothelial cell loss and disruptions in HEX.Despite endothelial changes,corneal densitometry remained stable postoperatively,suggesting that current phacoemulsification techniques can achieve corneal clarity comparable to that of early stage cataract surgeries in cases with dense cataracts.
Presenting Author
Sibel Ahmet, FEBO, FRCSEd, MD
Co-Authors
Roberto Pineda MD
Purpose
To evaluate the early visual outcomes after cataract surgery with IC-8 Aphtera intraocular lens (IOL) in patients who developed cataract years after radial keratotomy (RK) and had visual symptoms such as halo, glare, ghosting, light sensitivity and blurred vision.
Methods
Seven eyes of 6 patients with a history of myopic radial keratotomy (RK) who underwent IC-8 IOL implantation between April and May 2024 were retrospectively evaluated. Uncorrected and best corrected visual acuities (UCVA, BCVA), manifest refractions, corneal topography values were analyzed.
Results
The mean age of the patients was 63 � 8.89 (51-72) years, 4 were female and 2 were male. There were 8 RK scars in 2 eyes and 12 RK scars in 5 eyes. Mean K1 was 33.60 � 3.92, K2; 36.70 � 2.80, and Kmax; 49.90 � 3.98. Better uncorrected and corrected distance visual acuity (VA) was achieved in most patients (p:0.05, p:0.03, respectively). Postoperative spherical, cylindrical and spherical equivalan values showed no statistically significant change compared to the preoperative period (each p>0.05). Although the number of cases was insufficient for statistical calculation, these patients who underwent IC-8 IOL implantation described subjective improvement in visual symptoms.
Conclusion
The IC-8 IOL offers promising results in patients experiencing visual symptoms after radial keratotomy. However, preoperative counseling about patient expectations and the effects of the IOL on visual symptoms is recommended.
Presenting Author
Ahmed Sallam, MD, PhD, FRCOphth
Co-Authors
Asad Loya MD, Muhammad Chauhan MS, MD, Zain Hussain MD, Mohmed Soliman MD, PhD
Purpose
Purpose: To assess the influence of modern cataract surgery on the progression from non-proliferative diabetic retinopathy (NPDR) to proliferative diabetic retinopathy (PDR) in patients with type 2 diabetes (T2D).
Methods
A retrospective analysis of real-world data from June 2004 to June 2024 within the TriNetX United States (US) Collaborative research network. Subjects were 18 years or older with T2D and NPDR who either underwent routine uncomplicated cataract surgery or did not receive cataract surgery. Propensity score matching (PSM) was performed to balance baseline demographic and clinical characteristics. Outcome Measures included risk of first-time diagnosis of PDR, vitreous hemorrhage (VH), tractional retinal detachment (TRD) or combined tractional and rhegmatogenous retinal detachment (CTRD), and a composite outcome at 6 months, 9 months, 1 year, 3 years.
Results
After PSM, there were 7178 patients in the study (n=3589) and control (n=3589) cohorts for right eye analysis. Following cataract surgery, increased risk of PDR without complications, VH, and the composite outcome were found at all assessed time intervals in the right eye analysis (all P<0.05). Right eye sensitivity analysis (n=4976) and left eye analysis (n=7232) outcomes were concordant with those of the right eye at all assessed time intervals except at 6 months. There was no significant difference in the risk for TRD or CTRD at any time point in all analyses (all P>0.05).
Conclusion
Modern cataract surgery could be associated with progression from T2D NPDR to PDR at least 9 months postoperatively.
Presenting Author
Gautam Ramanathan, BA
Co-Authors
Alex Liu BA, Stephen Scoper MD, Walter Whitley OD, Thomas Cheezum OD, Albert Cheung MD
Purpose
To describe our experience with utilizing a postoperative day one telehealth (TH) follow-up with uncomplicated cataract surgeries and assess its safety profile.
Methods
A retrospective chart review was performed for patients undergoing routine, uncomplicated cataract surgeries with postoperative day one TH follow-up from January 1, 2021 � December 31, 2023 for two cataract surgeons at Virginia Eye Consultants (SVS, AYC). Exclusion criteria included any complex cataract surgeries, intraoperative surgery complications, and incomplete in-person follow up or non-adherence to follow-up. Outcome measures included postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), as well as rate and management of adverse events.
Results
There were 5,335 total eyes (OD = 2679, OS = 2686) with postoperative day one TH visits that were included in this study. Detected adverse events during the TH follow-up included elevated IOP (n = 11, 1.7%), and corneal dryness (n = 1, 0.02%). At the in-person week one visit, detected adverse events included retained lens fragments (n=3, 0.06%), endophthalmitis (n=2, 0.04%) and high IOP (n = 3, 0.06%). At the in-person month one visit, detected adverse events included retained lens fragments (n=1, 0.02%), and high IOP (n=1, 0.02%). Both cases of endophthalmitis were managed appropriately with good outcomes. Postoperative BCVA improved from preoperative BCVA.
Conclusion
TH visits performed well as an effective triage system. Patients with adverse events were promptly identified, and complications were treated appropriately. The rates of endophthalmitis and retained lens fragments were lower or comparable to the current literature, respectively.
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