Author’s Disclosure Block: Zaynab Somani: none; Amos Kibata Githeko: Please note this author is being credited as a posthumous author in the study, and thus does not have any financial relationships to disclose.; Jean Junior Nkuyubwatsi: none; Fariba Nazemi: none.; Sohel Somani: Appelis - Consultant/Advisor. Bayer - Consultant/Advisor. Abvie - Research/Grant Support. Ripple Therapeutics - Consultant/Advisor.; Eric Tam: none.

Abstract Body
Purpose/Study Design: A mixed-methods study consisting of a retrospective chart review and qualitative interviews was conducted to determine factors influencing absent and delayed post-cataract surgery follow-up at City Eye Hospital in Nyeri, by comparing quantitative ocular data and qualitative insights between patients present at their one-month follow-up appointment after cataract surgery and those absent or delayed by at least one week. Methods: A mixed-methods case study was done for 50 adult patients who attended and 50 who were absent (or delayed by at least a week) from their one-month follow-up after cataract surgery between November 2023 andApril 2024. A de-identified retrospective chart review collected past medical history, surgical data (such as complications), and pre- and post-operative ocular data (including visual acuity, intraocular pressure, and refraction). The patients were then interviewed in Kikuyu or Kiswahili to determine their travel costs, financial barriers, perceived visual status after surgery, perceived understanding of the surgery and recovery, education level, and priorities influencing follow-up. Results/Conclusions:Non-follow-up patients had a lower pre-operative visual acuity (p=0.002) than follow-up patients. Follow-up patients had a higher day 1 post-operative visual acuity (p=0.012) than non-follow-up patients. Non-follow-up patients had a larger improvement in their visual acuity after cataract surgery (p<0.001). On average, non-follow-up patients spent 30.2% more time traveling than non-follow-up patients (p=0.007). The average transport cost was increased by 35.5% for non-follow-up patients compared to follow-up patients (p=0.030); the average travel cost was $8.43 CAD (KSH 760.51) for non-follow-up patients compared to $6.23 CAD (KSH 561.65) for follow-up patients. Non-follow-up patients may have perceived a greater improvement in their vision compared to their baseline, reducing their motivation to follow-up. Patient education should emphasize the necessity to follow-up regardless of perceived visual improvement. Hospitals should consider facilitating patient transport to improve post-operative follow-up.