Acceptability Of Immediate Sequential Bilateral Cataract Surgery In Patients Following First Eye Surgery Of Delayed Sequential Bilateral Cataract Surgery

Cataract surgery provides an improvement in quality of life and visual function. It is one of the most commonly performed surgical procedures worldwide and current demand is increasing. A paradigm shift is occurring with the promotion of immediate sequential bilateral cataract surgery (ISBCS) rather than delayed sequential bilateral cataract surgery (DSBCS) as ISBCS is more cost effective for hospitals and preferred by some patients. A recent study described patient attitudes towards ISBCS during COVID-19 lockdowns (Shah 2020) but there is limited information with regards to patient attitudes during non-lockdown periods.

 

A single surgeon’s private practice within two hospitals in Greater London, UK.

 

An anonymised questionnaire including eight questions was designed and administered to patients in the first few weeks following the first eye surgery of their DSBCS. The questionnaire enquired regarding patient age, gender, the number of days since the first eye operation, the implant type, the journey time from home to hospital on the day of surgery and the retrospective tolerability of ISBCS versus DSBCS and the reasons for this decision.

 

There were 32 respondents. Mean age was 68 years old, 56% (n=18) of respondents were female. Mean interval from surgery to survey was 8.8 days. 59% (n=19) of lenses were monofocal, 25% (n=8) multifocal and 16% (n=5) toric. 41% (n=13) patients preferred ISBCS to DSBCS. This acceptability was similar across all age groups, genders, and journey time to hospital. Patient reasoning for supporting DSBCS related to concerns regarding complications, struggling with activities of daily living in the days immediately following surgery and distress due to post-operative symptoms. Reasons for supporting ISBCS were the shorter recovery period, avoiding anisometropia, fewer hospital visits and having support to cope in the immediate post-operative days.

 

ISBCS is a key tool to help manage rising demand for cataract surgery in the 21^st century. Understanding patient’s motivations and concerns is key to ensure appropriate and optimal uptake of ISBCS when suitable. ISBCS would have preferrable to 41% of our population suggesting that limited routine implementation is feasible. Providing patients with information including the risks and benefits in line with the survey results gathered is key to identify those who would wish to proceed with ISBCS and most likely benefit.