Evaluation of the use of a nurse-administered telephone questionnaire for post-operative cataract surgery review

Abstract

Purpose – The purpose of this paper is to determine the safety of substituting the first day post-operative review after routine cataract surgery (phacoemulsification) with a telephone survey. Design/methodology/approach – Prospective non-randomised cohort study. A standardised questionnaire of five common ocular symptoms (general condition, vision, eye pain, headache, nausea or vomiting) was administered by a trained nurse on the first post-operative day. The patients were reviewed in clinic two to 14 days later. Patient charts were retrospectively reviewed for complications (endophthalmitis, raised intra-ocular pressure, wound leaks and uveitis) requiring deviation from standard treatment. Findings – Over 13 months, 256 eyes of 238 patients underwent uncomplicated phacoemulsification by four consultant surgeons. Only one patient reported poor general condition, blurred vision and eye pain. She was subsequently found to have corneal oedema and raised intra-ocular pressure when recalled for an earlier review. Best corrected visual acuity better than 20/40 was achieved in 80.5 per cent of patients. There were no other post-operative complications noted from medical records review. Research limitations/implications – Non-randomised nature, skewed surgical expertise, lack of a control group and patient experience data. In all, 22 patients (9.2 per cent) were also uncontactable for the telephone interview. Practical implications – A nurse-administered telephone survey seemed to be a safe and effective alternative to first day post-operative review after routine phacoemulsification. The survey also enabled the detection of serious post-operative complications. The first day post-operative hospital visit may be safely substituted in a selected patient population with greater patient convenience achieved and liberation of clinic resources. Originality/value – This is the first study which utilises a standardised questionnaire as a form of post-operative review in an Asian population.