Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 28:18:1515-1523.
doi: 10.2147/OPTH.S459266. eCollection 2024.

Immediate Sequential Bilateral Cataract Surgery in Patients with Bilateral Visually Significant Cataracts

Dasi Raju  1 , Stephen J Hannan  1 , Mirna Belovari  1 , Noelle C Hannan  1 , Colin W Berry  1 , Jan A Venter  1 , David Teenan  1 , Steven C Schallhorn  2   3 , Julie M Schallhorn  2   4
Affiliations

Immediate Sequential Bilateral Cataract Surgery in Patients with Bilateral Visually Significant Cataracts

Dasi Raju et al. Clin Ophthalmol. .

Abstract

Purpose: To report our experience of performing immediate sequential bilateral cataract surgery (ISBCS) in patients with visually significant cataracts and reduced preoperative corrected distance visual acuity (CDVA).

Methods: Data of patients who underwent ISBCS for visually significant cataracts and had preoperative CDVA ≤20/32 (≤0.2 logMAR) in each eye were retrospectively reviewed. Refractive and visual outcomes were evaluated for the last available postoperative visit. Intraoperative and serious postoperative adverse events occurring within the first three months of surgery were reviewed.

Results: A total of 1335 patients (2670 eyes) were included in the analysis, with a mean age of 71.9 ± 9.5 years. On the last visit, 50.2% and 89.1% of eyes achieved uncorrected distance visual acuity (UDVA) ≥20/20 (0.0 logMAR) and ≥20/32 (0.2 logMAR), respectively. Of all eyes, 83.8% were within ±0.50D, and 96.4% were within ±1.00 D of emmetropia. Ten patients had postoperative bilateral ametropia of more than 1.00D in each eye, but eight of them still achieved binocular UDVA ≥20/40. Intraoperative events occurred in 14 eyes of 13 patients (per-eye incidence: 0.524% or 1 in 191 eyes). A total of 86 postoperative adverse events occurred in 80 eyes of 53 patients (per-eye incidence 2.996% or 1 in 33 eyes), of which cystoid macular edema was the most common. Only three eyes had CDVA reduced by more than two Snellen lines compared to preoperative CDVA, two of which were not related to cataract surgery. There was no patient with bilateral CDVA loss.

Conclusion: In our cohort of patients with visually significant cataracts, ISBCS resulted in good refractive predictability and a low incidence of serious adverse events.

Keywords: adverse events; immediate sequential bilateral cataract surgery; refractive outcomes; visual outcomes.

PubMed Disclaimer

Conflict of interest statement

Dasi Raju, Stephen Hannan, Mirna Belovari, Noelle Hannan, Colin Berry, Jan Venter, and David Teenan are employees of Optical Express. Steven Schallhorn is a chief medical officer for Carl Zeiss Meditec and a chairman of medical advisory board for Optical Express. Julie Schallhorn received personal fees from Carl Zeiss Meditec, Allergan, ViaLase, Long Bridge, and Forsight V6 and has a financial interest in Journey 1, Neurotrigger, and Novus Vision. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Refractive and visual outcomes of patients with a minimum of one-month postoperative visit. Outcomes are based on the last available follow-up visit (mean follow-up 3.3 ± 3.4 months). (A) Cumulative postoperative monocular uncorrected (UDVA) and corrected (CDVA) distance visual acuity; (B) A histogram of the difference between postoperative UDVA and postoperative CDVA; (C) The distribution of postoperative manifest spherical equivalent (MSE). (D) The distribution of preoperative and postoperative refractive astigmatism.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Amsden LB, Shorstein NH, Fevrier H, Liu L, Carolan J, Herrinton LJ. Immediate sequential bilateral cataract surgery: surgeon preferences and concerns. Can J Ophthalmol. 2018;53(4):337–341. doi:10.1016/j.jcjo.2017.10.034 - DOI - PubMed
    1. Singh R, Dohlman TH, Sun G. Immediately sequential bilateral cataract surgery: advantages and disadvantages. Curr Opin Ophthalmol. 2017;28(1):81–86. doi:10.1097/ICU.0000000000000327 - DOI - PubMed
    1. Hannan SJ, Schallhorn SC, Venter JA, Teenan D, Schallhorn JM. Immediate sequential bilateral surgery in refractive lens exchange patients: clinical outcomes and adverse events. Ophthalmology. 2023;130(9):924–936. doi:10.1016/j.ophtha.2023.04.013 - DOI - PubMed
    1. Mills EC, Zarei-Ghanavati M, Liu CSC. Immediate sequential bilateral cataract surgery: the rationale, implementation, and beliefs of ophthalmic surgeons across Europe. J Cataract Refract Surg. 2019;45(12):1725–1731. doi:10.1016/j.jcrs.2019.07.027 - DOI - PubMed
    1. Buchan JC, Donachie PHJ, Cassels-Brown A, et al. The royal college of ophthalmologists’ national ophthalmology database study of cataract surgery: report 7, immediate sequential bilateral cataract surgery in the UK: current practice and patient selection. Eye. 2020. doi:10.1038/s41433-019-0761-z - DOI - PMC - PubMed