Impact of Day Care Surgery on In-patient Surgery for Age-Related Cataract in Faisalabad

Purpose: To establish reliability regarding the success, feasibility, cost-effectiveness of cataract extraction performed as day care surgery rather than in-patient procedure. Study design: This was a comparative observational study conducted from February 2008 to July 2010 by comparing the postoperative complications and the final visual outcome after eight weeks in day care and in-patient surgery for age-related cataract. Material and methods: Patients underwent surgery for age-related cataract at five cataract centers in Faisalabad, were included in this study. All patients underwent thorough ocular examination including anterior and posterior segment and made medically fit before surgery. Maculopathies, ocular fundus pathologies, glaucoma, previous ocular surgery, corneal opacity were excluded. Data was collected and analyzed by SPSS. Results: A total of 1219 cases, out of which 1110(91%) were day care surgeries, while 109(09%) were inpatient surgeries. Mean age of the subjects in the inpatient group was 62.1 years (SD=6.49 years), while in the daycare group mean age was 64.4 years (SD=5.73 years). The results of the t-test showed that age was not significantly different in both groups (p>0.05). There is no statistically significant difference in early postoperative complication rates in the day care surgeries and inpatient surgeries. These complications have no clinically significant effect on final visual outcomes eight weeks postoperatively. The mean change in visual acuity (Snellen lines) of the operated eye eight weeks postoperatively was not statistically significant. Patients in day care surgeries were more satisfied due to shifting to home after one hour postoperatively. Costs were 20% more for the in-patient group and this was attributed to higher costs for overnight stay. Conclusion: The success, safety, patient satisfaction and cost-effectiveness of cataract surgery as day care procedure appear to be acceptable. This study provides some evidence that there is a cost saving but no significant differences in final visual outcome between day care and in-patient cataract surgery.