Author’s Disclosure Block: Parsa Mehraban Far, none; Arman Rahimi Far, none; Julia Wiens, none; Andre Jastrzebski, none; Raageen Kanjee, none

Abstract Body
Purpose: To determine if early (day 0-1) post-operative assessment of patients following uncomplicated phacoemulsification can be safely replaced with a telephone screening tool administered within 24 hours of surgery. Study Design: Retrospective cohort study. Methods: Single-centre retrospective cohort study of two independent cataract surgeons (AJ, RK). Ethics approval was obtained from Health Research Ethics Board at the University of Manitoba. Consecutive adult patients (>18 years age) undergoing uncomplicated phacoemulsification were enrolled. Additional exclusion criteria included pre-existing glaucoma, ocular hypertension, severe uveitis, limited vision in the fellow eye, limited psychosocial supports at home, and lack of access to a telephone post-operatively. Patients in the intervention arm underwent a telephone interview using a standardized questionnaire (https://rb.gy/0a1zxu). The questionnaire was adapted from a prior publication and was comprised of four questions, each with a low-risk or high-risk answer. Patients with high-risk answers were invited back for an in-office examination at the discretion of the surgeon. The control arm included patients undergoing uncomplicated phacoemulsification prior to the introduction of the telephone screening tool. These patients received regular early post-operative examination within 24 hours with no telephone screening. The same inclusion and exclusion criteria from the intervention cohort was also applied to the control cohort. All patients underwent a final in-office examination 3-weeks post-operatively. Primary outcomes included visual acuity, intraocular pressure (IOP), and rate of unscheduled office appointments. Results: Patients were consecutively enrolled in the control cohort starting from September 2019, and in the intervention, cohort starting from September 2020. A total of 291 patients, including 146 intervention and 145 control patients, were included in the study. The mean logMAR (standard deviation (SD)) post-operative uncorrected distance visual acuity and best corrected distance visual acuity were 0.27 (0.24) and 0.15 (0.15) respectively in the intervention group, both of which were comparable to the control group (Independent t-test; p=0.35, p=0.55 respectively). Pre-operative IOP was lower in the intervention group (Independent t-test; p=0.007) at 15 (3.0) in comparison to 16 (2.9). IOP remained lower in the intervention group post-operatively (Independent t-test; p=0.0009) at 14 (3.0) in comparison to 16 (2.9). There were 9 patients requiring unscheduled visits in the intervention cohort in comparison to 5 in the control cohort (X2=1.17; p=0.28). Conclusions: Deferring early post-operative visits in appropriately selected patients undergoing uncomplicated phacoemulsification surgery is safe, and patients achieve equivalent outcomes with fewer unscheduled in-office visits.