Simultaneous bilateral versus sequential bilateral cataract surgery: Helsinki Simultaneous Bilateral Cataract Surgery Study Report 1

Abstract

No author has a financial or proprietary interest in any material or method mentioned.

Immediately sequential versus delayed sequential bilateral cataract surgery: Safety and effectiveness

“…7,14 Evidence-based clinical and policy decisions on the choice of operative technique require more robust scientific knowledge about safety, effectiveness, and cost effectiveness. One recent clinical trial 15 and 1 economic analysis 16 support the previous findings in several case series. [3][4][5][6][7][8][9][10][11] These studies found that patients treated with ISBCS recovered visual function faster with no increase in the risk for relevant complications.…”

Safety and efficacy of simultaneous bilateral 25-gauge lens-sparing vitrectomy for vascularly active stage 4 retinopathy of prematurity

“…7 However, it still remains quite controversial 3,8 as one of the main reasons is risk of bilateral endophthalmitis, which could lead to bilateral visual loss. The reported incidence of endophthalmitis following simultaneous bilateral cataract surgery is between 0.15 and 1.1%, as compared with 0.1% or less following unilateral or sequential cataract extractions.…”

‘Bilateral same-day cataract surgery should routinely be offered to patients’ – No

“…7 Furthermore, the visual benefit of same-day surgery is also short-lived and by 4 months there is no significant difference between ISCS and sequential surgery with a 2-month interval. 5 If it can be determined whether patients are happy to wait until the success of the first-eye surgery, it would seem prudent to do so.…”

“…5 With appropriate case selection 6 and precautions against endophthalmitis and refractive surprise, ISCS can result in excellent outcomes and high levels of patient satisfaction. 1,7,8 Despite growing interest, in most countries ISCS remains the exception rather than the rule, and it is our view that it should remain this way and that bilateral cataract surgery should not be routinely offered to patients. The arguments in favour of same-day bilateral surgery are primarily related to convenience and economy, 9 but these benefits are outweighed in most circumstances by the small but devastating risk of bilateral blindness due to a complication of surgery.…”