Postoperative care

Quality statement 8 - Cataract Clinical Care Standard

A patient receives postoperative care that ensures the early detection and treatment of complications of cataract surgery, and the patient’s visual rehabilitation. Postoperative care is provided by the operating ophthalmologist or a designated team member. The patient is informed of the arrangements for postoperative care.

Purpose

To ensure that a patient remains under the care of the operating ophthalmologist (or, where necessary, that this care is delegated to an appropriately qualified clinician) until they have recovered from cataract surgery.

For patients

Your eye surgeon (and members of the eye team) will see you regularly while you recover from cataract surgery, until your eyes have fully recovered from the surgery. Usually, this will mean a check-up in the first 48 hours and again 2–4 weeks after surgery. They will look at your eye to check how well it is healing and how well you can see. They will provide information about:

  • What you can expect while your eye is healing
     
  • How to look after your eye while it is healing, including any eye drops needed
     
  • When to have your eyes checked after the operation so that any problems can be treated early, even though the risk of complications after surgery is usually low
     
  • When to get new glasses, if this applies to you.

It is important that you know who to contact if you have any concerns or questions, or if your vision changes unexpectedly. If you have cataract in your non-operated eye, your eye surgeon will talk to you about your options for future surgery, usually based on the recovery of your operated eye.

For clinicians

Ensure appropriate postoperative care by regularly reviewing the patient’s postoperative recovery. Determine the exact frequency of postoperative review, taking into account the surgical technique, any operative or postoperative complications, and the person’s ability to access care.8 Early review (within 24 hours) may be warranted for patients at high risk of complications, but may be deferred for up to two weeks in uncomplicated cataract surgery in patients not at risk of intra-ocular pressure increase.4,8,36 Inform patients about the need for follow-up appointments and how to recognise potentially important visual changes. Provide details of who to contact in case of concerns.

Postoperative care is the responsibility of the operating ophthalmologist. If this is not possible – for example, for some rural and remote patients – care should be delegated to an appropriately qualified clinician with adequate clinical handover, considering the patient’s ability to access services. Ensure that this team member has the patient’s preoperative assessment and details of the surgery performed, is able to recognise complications, and can access urgent referral and specialist support if needed.

Provide patients with information about what to expect during the postoperative period, how to care for their eye postoperatively, use of medications, second-eye surgery (where relevant) and when to get new glasses (if appropriate). Include this information in reports back to the referring clinician, including details of intracameral antibiotics administered during surgery.

For health service organisations

Ensure that clinicians have access to local guidelines or protocols for appropriate postoperative care, and that processes are in place to promptly identify and
manage complications.

When postoperative care will be provided by a clinician other than the operating ophthalmologist, ensure appropriate handover of clinical information required to provide postoperative care. Ensure that systems are in place to provide patients with access to emergency specialist ophthalmology services as needed.

Ensure that policies and procedures for information management and communication support the reporting of surgical outcomes to referring clinicians, other relevant clinicians and the patient, and that responsibilities are clearly delineated.

For patients

Your eye surgeon (and members of the eye team) will see you regularly while you recover from cataract surgery, until your eyes have fully recovered from the surgery. Usually, this will mean a check-up in the first 48 hours and again 2–4 weeks after surgery. They will look at your eye to check how well it is healing and how well you can see. They will provide information about:

  • What you can expect while your eye is healing
     
  • How to look after your eye while it is healing, including any eye drops needed
     
  • When to have your eyes checked after the operation so that any problems can be treated early, even though the risk of complications after surgery is usually low
     
  • When to get new glasses, if this applies to you.

It is important that you know who to contact if you have any concerns or questions, or if your vision changes unexpectedly. If you have cataract in your non-operated eye, your eye surgeon will talk to you about your options for future surgery, usually based on the recovery of your operated eye.

For clinicians

Ensure appropriate postoperative care by regularly reviewing the patient’s postoperative recovery. Determine the exact frequency of postoperative review, taking into account the surgical technique, any operative or postoperative complications, and the person’s ability to access care.8 Early review (within 24 hours) may be warranted for patients at high risk of complications, but may be deferred for up to two weeks in uncomplicated cataract surgery in patients not at risk of intra-ocular pressure increase.4,8,36 Inform patients about the need for follow-up appointments and how to recognise potentially important visual changes. Provide details of who to contact in case of concerns.

Postoperative care is the responsibility of the operating ophthalmologist. If this is not possible – for example, for some rural and remote patients – care should be delegated to an appropriately qualified clinician with adequate clinical handover, considering the patient’s ability to access services. Ensure that this team member has the patient’s preoperative assessment and details of the surgery performed, is able to recognise complications, and can access urgent referral and specialist support if needed.

Provide patients with information about what to expect during the postoperative period, how to care for their eye postoperatively, use of medications, second-eye surgery (where relevant) and when to get new glasses (if appropriate). Include this information in reports back to the referring clinician, including details of intracameral antibiotics administered during surgery.

For health service organisations

Ensure that clinicians have access to local guidelines or protocols for appropriate postoperative care, and that processes are in place to promptly identify and
manage complications.

When postoperative care will be provided by a clinician other than the operating ophthalmologist, ensure appropriate handover of clinical information required to provide postoperative care. Ensure that systems are in place to provide patients with access to emergency specialist ophthalmology services as needed.

Ensure that policies and procedures for information management and communication support the reporting of surgical outcomes to referring clinicians, other relevant clinicians and the patient, and that responsibilities are clearly delineated.