Complications of uneventful phacoemulsification on the first postoperative day: to determine the necessity of the first day review

Abstract

Purpose: To establish the type and number of complications detected on the first postoperative day and to determine the necessity of the first day review.

Study design: Clinical audit.

Methods: This is a retrospective review of 297 patients who underwent routine phacoemulsification cataract surgery by qualified ophthalmologists and trainees from September to December 2020 at our day-care operation theatre. All cases of uncomplicated phacoemulsification were analysed for the types and frequency of
complications on postoperative day one.

Results: Of 297 cases of routine cataract surgery, 6.7% of cases were excluded due to intraoperative complications. Of the remaining 277 cases, a total of 54 cases (19.5%) were found to have complications on day 1 postoperative review. These included raised intraocular pressure (67.0%), epithelial defect (20.0%), intense inflammation with presence of fibrin (5.0%), retained soft lens matter (4.0%), retained fibres (2.0%), and exposed corneal suture (2.0%). Two patients (0.7%) needed the removal of soft lens matter. Of 36 cases of raised intraocular pressure, 1 patient required anterior chamber paracentesis for retained viscoelastic, 18 patients required topical antiglaucoma medication, 15 patients needed systemic oral acetazolamide, and 2 patients with pre-existing glaucoma were instructed to continue their antiglaucoma medications.

Conclusions: Following uneventful phacoemulsification, only 19.5% of patients were found to have complications on day 1 postoperative review. The most frequent complication was raised intraocular pressure, which can be detected on the day of surgery. Reviewing patients on the same day of surgery can reduce workload and demands on clinician time. It can also significantly reduce health care costs without compromising patient safety.