Comparison of results of bilateral simultaneous and bilateral sequential cataract surgery

Poster Details

First Author: R.Bharti INDIA

Co Author(s):    S. Bharti              

Abstract Details

Purpose:

To compare safety , efficacy , Refractive results and visual performance in patients undergoing cataract surgery in both eyes simultaneously with those undergoing it sequentially after a gap of 7 days or more.

Setting:

Bharti Eye Foundation, East Patel Nagar, New Delhi, India

Methods:

This study comprises of 208 eyes of 104 patients undergoing bilateral cataract surgery in one center by the same surgeon(SB) with a minimum followup of 3 months. These are divided into 2 groups. Group 1 is a cohort of 68 eyes of 34 patients undergoing cataract surgery in both eyes in a single sitting and Group 2 is formed by 140 eyes of 70 patients who underwent both eye cataract surgery after a gap of over 7 days upto 3 months. All the patients underwent a routine eye examination including a fundus examination and routine heamatology , biochemistry and urinalysis. All those with any ocular disease were excluded from this study and diabetics without tight control were excluded from simultaneous surgery. The biometry in all the eyes was done with immersion method and SRK-T formula was used in all the cases. There were 52 males and 52 females with diabetics comprising 34%(12/34) of group 1 and 21% (15/70) of group 2.

Results:

At 21 days 85% (29/34) eyes in group 1 had equal BCVA in both eyes as compared to 81% (57/70) in group 2. There was no difference in refractive error of the 2 eyes in 41% (14/34) in group 1 as compared to 35% (25/70) in group 2 with adifference upto +/- 0.50 D in 53% of group 1 eyes and 57 % of group 2 eyes. Difference of 1D or more in 2 eyes was seen in 6% eyes in Group1 and in 7% eyes in group 2. There was no case of endophthalmitis in any of the eyes.

Conclusions:

Bilateral simultaneous cataract surgery is a safe modality and compares well with sequential cataract surgery and reduces the morbidity. A gap in performing surgery in 2 eyes is recommended to titrate the refractive results of first eye to get a better refractive result in the second eye. This study shows that if biometry is performed carefully, the refractive results are comparable with 2 eyes undergoing sequential cataract surgery. There is no incidence of increased complication rate in simultaneous surgery. FINANCIAL DISCLOSURE?: No