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A Systematic Review of the Literature on Immediately Sequential Bilateral Cataract Surgery (ISBCS)

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First Author: P.Maghsoudlou UK

Co Author(s):    I. Ahmed   T. McNally   A. Abraham   O. El-Haddad   A. Achiron   I. Zaheer     

Abstract Details

Purpose:

Immediately Sequential Bilateral Cataract Surgery (ISBCS) has increasingly been suggested as an option to provide a time-efficient and effective cataract service. However, there is considerable regional variation between countries. Surgeon concerns regarding safety and refractive outcomes have been suggested as the main cause behind this.

Setting:

Department of Ophthalmology, Great Western Hospital, Swindon, UK.

Methods:

Literature review to compare outcomes of patients receiving ISBCS compared to delayed sequential bilateral cataract surgery (DSBCS).

Results:

A non-significant improvement was seen in BCVA due to ISBCS when compared to DSBCS. There was no significant difference in the achievement of emmetropia or complications between ISBCS and DSBCS. Four cases of bilateral endophthalmitis after ISBCS have been reported in the past 60 years, all with breaches of aseptic protocol, such as the use of the same instruments in both eyes(50%). Theatre modelling suggests four ISBCS cases are required to allow an additional surgery to be conducted. Financial modelling demonstrated that ISBCS is associated with lower hospital costs and more efficient use of operating room and clinic.

Conclusions:

ISBCS is safe and effective, providing equal visual outcomes and complications if surgical guidelines are followed. Additional benefits include the reduced risk of a second general anaesthetic and reduced risk of SARS-CoV-2 exposure.

Financial Disclosure:

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