We investigated the proportions of immediate sequential bilateral cataract surgery (ISBCS) and unilateral cataract surgery during the coronavirus disease 2019 pandemic and compared visual outcomes between the two groups in a tertiary hospital in South Korea. We reviewed 441 cataract surgeries performed between March 1, 2021, and October 31, 2021, at Korea University Guro Hospital by a single surgeon (J.S.S). Medical records of demographics, preoperative visual acuity, corneal astigmatism, axial length, preoperative spherical equivalent, preoperative target (using Barrett’s Universal 2 formula), postoperative visual acuity, postoperative refractive error, and postoperative complications were evaluated. Among all patients, 322 (73.0%) eyes underwent ISBCS, and 119 (27.0%) eyes underwent unilateral cataract surgery. The preoperative corrective distance visual acuity (CDVA) was lower in the unilateral cataract surgery group (0.40 ± 0.45 logMAR) than the ISBCS group (0.28 ± 0.16 logMAR, P = 0.008), whereas there was no significant difference in postoperative CDVA between the two groups (0.06 ± 0.10 logMAR vs. 0.07 ± 0.16 logMAR, P = 0.63). There was also no difference in the absolute refractive error between the two groups (0.46 ± 0.37 diopters [D] vs. 0.42 ± 0.38 D, P = 0.63). The preoperative CDVA (P = 0.000) was the significant factor influencing absolute refractive error (r = 0.191, P < 0.001). There was no difference in complications between the two groups, although two patients in the ISBCS group complained of postoperative strabismus.
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