Virtual follow-up after cataract surgery: systematic review.

Topic: To examine the association between virtual postoperative follow-up care and patient outcomes after cataract surgery.

Clinical Relevance: Cataract surgery is a safe and commonly performed surgery. Follow-up visits are used to monitor for complications. It is uncertain whether virtual follow-up provides a safe alternative to in-person review.

Methods: MEDLINE, Embase, and CINAHL were searched from inception to October 2023 for relevant articles containing original data. Studies that (1) included patients who were seen in a virtual follow-up (ie, telephone or video call) for postoperative appointments after cataract surgery and (2) reported patient outcomes were included. Risk of bias (RoB) was assessed using the Newcastle-Ottawa and RoB2 assessment tools. Descriptive statistics were used to summarize findings. The review was registered in PROSPERO (registration number, CRD42023477207), and PRISMA guidelines were followed.

Results: The search yielded 1710 records with 7 studies included in this review. The 7 studies reported on 2113 cataract surgeries in 1994 patients. The studies ranged between 2004 and 2020. Most of the studies (5/7) included only patients with uneventful cataract surgery. Virtual follow-ups were all conducted by telephone. The follow-up calls were made at varying timepoints including postoperative day 1 (n = 3), day 7 (n = 2), and day 14 (n = 1). 2 observational studies directly compared patients who had a telephone follow-up with a control group who had an in-person follow-up. There were no significant differences in complication rates ( P = .22) or visual acuity ( P = .28) between these follow-up groups. None of the studies reported serious adverse outcomes from replacing in-person follow-up with telephone follow-up. One study used virtual follow-up in conjunction with in-person visits for elderly patients and found that additional telephone follow-up was associated with decreased surgical recovery time and decreased patient anxiety. 3 studies reported on patient perceptions about telephone follow-up. A common theme was that patients preferred telephone reviews and found them to be more convenient than in-person follow-up.

Conclusions: For patients with uneventful cataract surgery, virtual follow-ups seem to be a safe alternative to in-person visits and were preferred by patients. These conclusions are preliminary given the limited literature base, and further study is needed.