Women, younger patients most likely to heed follow-up advice

Investigators identified patient characteristics associated with follow-up compliance after cataract surgery.

Study design

Data from 86,776 cataract surgeries performed in 2015 were analyzed. Patients were asked to return for follow-up after 1 month. The authors examined if demographic characteristics, surgical factors and preoperative and discharge visual acuities were associated with follow-up rates. The behaviors of patients who complied with the follow-up advice were analyzed, including the number of days from surgery to follow-up and number of follow-up visits. Multivariate regression models were used to identify predictors associated with these behaviors.

Outcomes

The overall follow-up rate was 85.6%. Patients who were female, younger than 70 years, paying (versus subsidized or free) and had phacoemulsification (versus manual small incision cataract surgery) were more likely to return to their follow-up visit (all P<0.001). Patients who had complications, reoperations or poorer visual acuity at discharge were less likely to comply with the follow-up advice (P<0.001).

Limitations

This study analyzed data from a single center. The authors did not address correlation vs. causation. Conceivably, the patients who presented for surgery after their cataracts were already too dense for phaco are the patients who are less attentive to their medical care in general, and hence less likely to comply with postop instructions and follow-up.

Clinical significance

It is important to realize that the very patients least likely to comply with postop instructions and appointments happen to be the ones most in need of follow-up care—older, sicker patients who have more complex ocular problems. Interventions to increase follow-up rates should target patients with the characteristics found in this study.