Patients who undergo uncomplicated vitreoretinal surgery can safely be examined on the second postoperative day without negative effects, according to this small study.
Study design
This was a single-surgeon retrospective review of 134 patients who underwent vitreoretinal surgery. Each was seen on the second, but not the first day, after surgery. All patients received a phone call from a technician on the first day after surgery to assess for pain and vision issues.
Outcomes
Six patients had IOP greater than 30 mm Hg on the second postoperative day; all were managed medically. Only 1 patient was seen on the first postoperative day due to pain and elevated pressure.
There were no cases of endophthalmitis.
Limitations
The very rare but potential complication of endophthalmitis can be missed if a patient is not seen on postoperative day 1. The effect of elevated IOP—even for 1 day—in a patient with ischemic retina could lead to some loss of vision.
Most importantly, since postoperative day 1 visit has been standard of care, deviating from it could put physicians at a medico-legal risk in the event on an unfavorable outcome.
Clinical significance
It is unlikely that a significant postoperative complication would be missed by examining a patient on the second postoperative day. Having a technician speak to the patient on day 1 does add a measure of safety, according to this study.
With surgeons often visiting multiple offices, having patients seen on the second day, rather than the first, could create a more flexible and convenient option for patients.