Simultaneous bilateral cataract surgery in general anesthesia patients

Abstract

Background: The aim of this study was to evaluate the indications, safety, benefits, disadvantages and advantages, and the visual outcomes for simultaneous bilateral cataract surgery (SBCS) under general anesthesia.

Methods: This retrospective case review pertained to a period spanning from June 1998 through June 2005 inclusively, and comprised of 27 consecutive patients (54 eyes) that underwent simultaneous bilateral cataract surgery under general anesthesia at the Kaohsiung Chang Gung Memorial Hospital, Taiwan. Surgery modalities included phacoemulsification, extracapsular cataract extraction, lens aspiration and intraocular lens implantation. Outcome measures included postoperative best correct visual acuity (BCVA) as well as intraoperative and postoperative complication rates. Due to the bipolas distribution of the age, we arbitrarily divided our cases into younger group (Group Y, younger than 20 years old) and older group (Group O, equal to or older than 20 years old).

Results: Thirty-eight of the 54 eyes (60% in the younger group and 76.5% in the older group), featuring measured preoperative and postoperative BSCVA, achieved improved visual acuity following SBCS. Two eyes (5.9% in the older group) demonstrated poorer visual acuity postoperatively than preoperatively. Seven patients (40% in the younger group and 17.6% in the older group) were not able to express VA due to their particular medical conditions such as mental disease and young age. Intraoperative and postoperative complication rates were similar to those cited in previous reports of analogous but unilateral extracapsular surgery and simultaneous bilateral cataract surgery. Endophthalmitis did not arise in any of the eyes operated upon and reported on herein, and no examples of bilateral complications that resulted in visual loss occurred in our patients.

Conclusion: SBCS could be a good choice when cataract surgery needs to be performed under general anesthesia. The relative benefits of SBCS under general anesthesia could eclipse the associated enhanced risks of this surgery.