EC Ophthalmology

Introduction and Purpose: COVID-19 introduced pressures across the health service, including the need to minimise patient footfall in hospitals and local optometrists. Cataract surgery is the most commonly performed operation in the NHS, post-operative care representing a significant workload. Other hospitals have previously implemented telephone follow-ups and found it safe, effective and well received by patients. The RCOphth guidance on “Restarting and Redesigning cataract pathways in response to the COVID 19 pandemic” recommends considering telephone follow-up for uncomplicated cataract surgery, therefore it was trialled at Maidstone and Tunbridge Wells NHS Trust when surgery restarted after the first wave of the pandemic.

Setting: Telephone consultation for uncomplicated cataract surgery follow-up performed at Maidstone and Tunbridge Wells NHS Trust in Kent, UK.

Methods: This study included patients with no ocular co-morbidities who underwent uneventful cataract surgery. They were listed for telephone follow-up by the operating surgeon at the time of surgery. A telephone consultation follow-up was conducted by a one from a team of optometrists, nurses and a doctor. If the patient had any concerns which could be addressed or alleviated over the telephone the operating surgeon was informed and/or a face-to-face appointment arranged for the patient, as necessary. 

Results: One hundred and thirty eyes of 125 patients were scheduled for telephone consultation follow-up over 113 days. One hundred and twenty six out of 130 episodes were successfully contacted for telephone follow-up. Those who did not answer were contacted on multiple occasions, booked for clinic follow-up, or received written communication of our attempts. Follow-up intervals ranged between 8 to 57 days post-operatively. Concerns were reported in (12/126) 9.5% of episodes, leading to 6 face-to-face assessment requests. Analysis demonstrated 50% of those referred for face-to-face review were not appropriate for this method of follow-up due to ocular co-morbidities.

Conclusion: Telephone consultation is a safe and effective method of follow-up after routine cataract surgery in patients without any ocular co-morbidities. It is important to ensure appropriate patient selection as those with co-morbidities are more likely to experience concerns and benefit from a face-to-face review. In addition, patients with hearing difficulties, language barriers, or cognitive difficulties are not appropriate candidates for telephone follow-up for cataract surgery as nuances in the post-operative recovery cannot be not clearly relayed. 

Keywords: COVID-19 Pandemic; Telephone Follow-Up; Cataract Surgery

1. Buchan JC., et al. “The Royal College of Ophthalmologists’ National Ophthalmology Database study of cataract surgery: Report 7, immediate sequential bilateral cataract surgery in the UK: Current practice and patient selection”. Eye 10 (2020): 1866-1874.
2. The Royal College of Ophthalmologists. “Restarting and Redesigning Cataract Pathways in Response to the COVID-19 Pandemic”. London. The Royal College of Ophthalmologists (2020).
3. Hoffman JJSL and Pelosini L. “Telephone follow-up for cataract surgery: feasibility and patient satisfaction study”. International Journal of Health Care Quality Assurance 4 (2016): 407-416.