Predictors of patient compliance with follow-up visits after cataract surgery

Gupta, Sachin; Ravindran, Ravilla D.; Subburaman, Ganesh-Babu B; S, Ashok Vardhan; Ravilla, Thulasiraj

doi:10.1016/j.jcrs.2019.02.024

Cited by 13 publications

(14 citation statements)

References 18 publications

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“…Similarly, complicated cases were less adherent to follow-up in our study. This is in agreement with Gupta et al, 15 again possibly indicating patient frustration and switch of healthcare provider. Very young and very old patients demonstrated significantly higher risk for missed appointments, in accordance with other studies.…”

Section: Open Accesssupporting

confidence: 91%

“…We evaluated variables that were found to be associated with missed visits in ophthalmology and other clinical settings and were thought to be relevant in cataract surgery. [15][16][17][18][19][20][21][22][23] Age, gender, race/ethnicity, primary language, level of education, insurance type, ocular comorbidities, season of the year and primary surgeon variables were categorised based on clinical relevance. Estimated travel time (ETT) to the location of the scheduled visit was determined using zip codes and the Google Maps web service set on a fixed date and time.…”

Section: Datamentioning

confidence: 99%

“…In a large series from India, Gupta et al investigated predictors of compliance with cataract surgery follow-up. 15 However, that centre practised a follow-up pattern in which some patients were admitted to the hospital for 1–7 days, and socioeconomic factors were not studied. Two prior studies have small patient samples, 16 17 included surgical cases performed by trainees only, 16 17 evaluated non-attendance at a late (≥3 months) postoperative timepoint 16 or focused on an indigent, rural population.…”

Section: Introductionmentioning

confidence: 99%

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Healthcare disparities contribute to missed follow-up visits after cataract surgery in the USA: results from the perioperative care for intraocular lens study

et al. 2021

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ObjectiveTo identify factors that contribute to missed cataract surgery follow-up visits, with an emphasis on socioeconomic and demographic factors.MethodsIn this retrospective cohort study, patients who underwent cataract extraction by phacoemulsification at Massachusetts Eye and Ear between 1 January and 31 December 2014 were reviewed. Second eye cases, remote and international patients, patients with foreign insurance and combined cataract cases were excluded.ResultsA total of 1931 cases were reviewed and 1089 cases, corresponding to 3267 scheduled postoperative visits, were included. Of these visits, 157 (4.8%) were missed. Three (0.3%) postoperative day 1, 40 (3.7%) postoperative week 1 and 114 (10.5%) postoperative month 1 visits were missed. Age<30 years (adjusted OR (aOR)=8.2, 95% CI 1.9 to 35.2) and ≥90 years (aOR=5.7, 95% CI 2.0 to 15.6) compared with patients aged 70–79 years, estimated travel time of >2 hours (aOR=3.2, 95% CI 1.4 to 7.4), smokers (aOR=2.7, 95% CI 1.6 to 4.8) and complications identified up to the postoperative visit (aOR=1.4, 95% CI 1.0 to 2.1) predicted a higher rate of missed visits. Ocular comorbidities (aOR=0.7, 95% CI 0.5 to 1.0) and previous visit best-corrected visual acuity (BCVA) of 20/50–20/80 (aOR=0.4, 95% CI 0.3 to 0.7) and 20/90–20/200 (aOR=0.4, 95% CI 0.2 to 0.9), compared with BCVA at the previous visit of 20/40 or better, predicted a lower rate of missed visits. Gender, race/ethnicity, language, education, income, insurance, alcohol use and season of the year were not associated with missed visits.ConclusionsMedical factors and demographic characteristics, including patient age and distance from the hospital, are associated with missed follow-up visits in cataract surgery. Additional studies are needed to identify disparities in cataract postoperative care that are population-specific. This information can contribute to the implementation of policies and interventions for addressing them.

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Section: Open Accesssupporting

confidence: 91%

Section: Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Healthcare disparities contribute to missed follow-up visits after cataract surgery in the USA: results from the perioperative care for intraocular lens study

et al. 2021

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“…Studies done in India have shown a drop-out from follow-up of around 30% following cataract surgery mainly among patients undergoing surgery through outreach services and among older patients[ 9 10 ] In our study the unprompted follow-up rate was a good 91%. This was probably because of better awareness, good transport connectivity in the state, and our practice of ensuring a free review appointment for outreach patients before each patient is discharged.…”

Section: Discussionmentioning

confidence: 50%

Correlation between visual acuity at discharge and on final follow-up in patients undergoing manual small incision cataract surgery

Kurian

Amritanand

Mathew

et al. 2021

Indian Journal of Ophthalmology

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Purpose: The aim of this study was to determine the correlation between visual acuity on discharge and at final follow-up in patients undergoing manual small incision cataract surgery (MSICS) through outreach services of a tertiary care training center. Methods: A prospective observational study was done to determine the correlation between visual acuity on postoperative day 1 and final follow-up (4–8 weeks) among various categories of surgeons and surgical complications in patients who underwent MSICS between January 2018 and March 2018. Proportions of patients benefitting from refractive correction were also analyzed. Results: Of the 924 patients who underwent MSICS through outreach services during the study period 841 were eligible for the study. Follow-up rate at 4–8 weeks was 91%. Mean age was 61.6 (SD 9.2) years, 63% were females and 55% were operated by trainees. There was a positive correlation between visual acuity at day one and final follow-up with a Spearman's correlation coefficient of 0.375 and 0.403 for uncorrected (UCVA) and best corrected visual acuity (BCVA) respectively ( P < 0.001). The correlation coefficient, while still positive, was lower for trainees (0.287), as compared to consultants (0.492). At least two lines of improvement in visual acuity on refractive correction were found in 77% of patients. Conclusion: Visual acuity on the day of discharge may be a useful quality indicator of visual outcome for monitoring cataract surgical programs. However, a follow-up at 4–8 weeks is recommended for individual patient benefit and monitoring surgical quality especially in training hospitals.

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“…Loss to follow-up is a known issue in cataract patients, with one recent estimate from Gupta et al of about 15%. 37 Factors leading to noncompliance are complex and not well understood, with a paucity of literature specifically examining the reasons behind loss to follow-up, which could range from overall patient dissatisfaction with the entire surgical process to dissatisfaction with the surgeon. On a more positive note, we hypothesize that if patients are satisfied with their surgical outcomes, they prefer to not return for additional follow-up visits or take additional drugs.…”

Section: Discussionmentioning

confidence: 99%

The Effect Of Lifitegrast On Refractive Accuracy And Symptoms In Dry Eye Patients Undergoing Cataract Surgery

2019

CMR

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To determine the effect of lifitegrast ophthalmic solution 5% on improving the tear film, biometry/keratometry, and refractive accuracy for dry eye patients scheduled for cataract surgery. Patients and Methods: Multicenter, prospective, open-label study of 100 eyes of 100 patients undergoing cataract surgery who had a confirmed diagnosis of dry eye. Patients underwent biometry at baseline and again after a 28-day course of lifitegrast 5% BID. Primary outcome was an improvement in the accuracy of preoperative anterior corneal power measurements at predicting postoperative spherical equivalent (SE) pre-and post-lifitegrast treatment. Secondary outcomes included changes in dry eye symptoms and corneal staining. Results: The accuracy of the biometry readings for the achieved refractive SE: within 0.25 D in 47% and 50% of eyes before and after the initial lifitegrast treatment, respectively; within 0.5 D in 71% and 79% of eyes before and after the initial lifitegrast treatment; and within 0.75 D in 81% and 91% of eyes before and after the initial lifitegrast treatment (p < 0.04). Conclusion: Lifitegrast 5% significantly improved preoperative corneal surface measurement accuracy in patients with confirmed dry eye who were scheduled for cataract surgery.

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Predictors of patient compliance with follow-up visits after cataract surgery

Cited by 13 publications

References 18 publications

Healthcare disparities contribute to missed follow-up visits after cataract surgery in the USA: results from the perioperative care for intraocular lens study

Healthcare disparities contribute to missed follow-up visits after cataract surgery in the USA: results from the perioperative care for intraocular lens study

Correlation between visual acuity at discharge and on final follow-up in patients undergoing manual small incision cataract surgery

The Effect Of Lifitegrast On Refractive Accuracy And Symptoms In Dry Eye Patients Undergoing Cataract Surgery

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