Pros and Cons of Bilateral Immediately Sequential Cataract Surgery
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CATARACT & REFRACTIVE SURGERY (CE STARR AND A BRISSETTE, SECTION EDITORS)
Pros and Cons of Bilateral Immediately Sequential Cataract Surgery Derek W. DelMonte 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Immediately sequential bilateral cataract surgery (ISBCS) has been gaining attention over the past decade as a more efficient way to address the growing need for cataract removal in an aging population, and yet delayed sequential bilateral cataract surgery (DSBCS) remains the standard of care in many ophthalmologic communities. This review discusses some of the reasons surgeons have been hesitant to adopt ISBCS and hopes to address both the pros and cons of the procedure in the current medical environment. Recent Findings Many of the current arguments against the practice of ISBCS involve potential bilateral surgical complications and worse refractive outcomes; however, the literature to date does not support these arguments. The risk of unilateral vision threatening complications appears similar to DSBCL, and no cases of bilateral complications have been reported when the currently recommended protocols have been obeyed. Additionally, refractive targets have been similar to DSBCS in current published studies. Summary ISBCS appears to be a more efficient and cost-saving procedure that remains safe and effective for improving visual functioning in patients with bilateral visually significant cataracts. Keywords Bilateral cataract surgery . Same-day cataract surgery . Immediately sequential bilateral cataract surgery . Simultaneous bilateral cataract surgery
Introduction Same-day bilateral cataract surgery, also known as immediately sequential bilateral cataract surgery (ISBCS), has been gaining attention worldwide over the past several years. As the name implies, ISBCS involves performing bilateral cataract surgery on a patient in one operative setting. While the perceived advantages and disadvantages continue to be debated, it remains a polarizing topic in many ophthalmic communities [1]. The standard of care in most communities remains delayed sequential bilateral cataract surgery (DSBCS); however, more This article is part of the Topical Collection on Cataract & Refractive Surgery * Derek W. DelMonte [email protected] 1
Department of Ophthalmology, Cornea, Cataract and Refractive Surgery Services, Sue Anschutz-Rogers Eye Center, University of Colorado Medical School, 1675 Aurora Court, F731, Aurora, CO 80045, USA
ophthalmologists continue to try ISBCS, most notably in healthcare systems that do not penalize for simultaneous surgery [2•]. In these settings, visual outcomes and complications have so far shown to be similar [3••]. Several randomized controlled trials have also demonstrated the safety and effectiveness of ISBCS [4–6]. Performing ISBCS is not a new practice and has been performed since the 1950s; however, due to the relative surgical risks of the time, it did not become the standard of care [7]. More recently, surgeons have considere
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