Augmentation of telemedicine post-operative follow-up after oculofacial plastic surgery with a self-guided patient tool

ABSTRACT

Purpose

This study evaluates a web-based tool designed to augment telemedicine post-operative visits after periocular surgery.

Methods

Adult, English-speaking patients undergoing periocular surgery with telemedicine follow-up were studied prospectively in this interventional case series. Participants submitted visual acuity measurements and photographs via a web-based tool prior to routine telemedicine post-operative visits. An after-visit survey assessed patient perceptions. Surgeons rated photographs and live video for quality and blurriness; external raters also evaluated photographs. Images were analyzed for facial centration, resolution, and algorithmically detected blur. Complications were recorded and graded for severity and relation to telemedicine.

Results

Seventy-nine patients were recruited. Surgeons requested an in-person assessment for six patients (7.6%) due to inadequate evaluation by telemedicine. Surgeons rated patient-provided photographs to be of higher quality than live video at the time of the post-operative visit (p < 0.001). Image blur and resolution had moderate and weak correlation with photograph quality, respectively. A photograph blur detection algorithm demonstrated sensitivity of 85.5% and specificity of 75.1%. One patient experienced a wound dehiscence with a possible relationship to inadequate evaluation during telemedicine follow-up. Patients rated the telemedicine experience and their comfort with the structure of the visit highly.

Conclusions

Augmented telemedicine follow-up after oculofacial plastic surgery is associated with high patient satisfaction, rare conversion to clinic evaluation, and few related post-operative complications. Automated detection of image resolution and blur may play a role in screening photographs for subsequent iterations of the web-based tool.

KEYWORDS:

• Oculofacial
• periocular
• post-operative
• telehealth
• telemedicine

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/01676830.2022.2104325.

Additional information

Funding

This work was supported by the NIH-NEI under P30 EY002162–Core Grant for Vision Research and by Research to Prevent Blindnesss under an unrestricted grant.