Patient-Reported Visual Outcomes In Immediately Compared To Delayed Sequential Bilateral Cataract Surgery

To evaluate the perception and self-reported visual outcomes of immediately sequential bilateral cataract surgery (ISBCS) compared to delayed sequential bilateral cataract surgery (DSBCS) among patients.

Single academic tertiary care center.

This is a prospective observational cohort study surveying patients who underwent cataract surgery at the CHU de Québec - Université Laval between August 2021 and September 2021 using the Catquest-9SF questionnaire, a 9-point questionnaire for measuring visual disability after cataract surgery. It was administered on the day of surgery for ISBCS patients and on the day of first eye surgery for DSBCS patients. The questionnaire was administered again 1 month postoperatively for ISBCS patients and 1 month postoperatively after each surgery for DSBCS patients. Pre- and postoperative results were compared between the two using mean Rasch scores for each patient, a higher score denoting greater visual impairment.

A total of 186 patients (ISBCS: n=152 vs. DSBCS: n=34) were included. There was no significant difference in baseline median [Q1, Q3] Catquest-9SF score (ISBCS: −1.42 [−2.39, −0.15] vs. DSBCS: −2.21 [−2.97, 0.08]; p=0.17). At 1 month postoperatively, ISBCS patients had a greater decrease in Catquest-9SF score compared to DSBCS patients, improving −1.90 [−3.17, −0.91] compared to −0.67 [−1.81, −0.02] (p<0.001). At 1 month after the second eye surgery, DSBCS patients had achieved similar improvement compared to ISBCS patients (ISBCS: −1.90 [−3.17, −0.91] vs. DSBCS: −1.29 [−2.17, −0.83]; p=0.18). In multiple linear regression analysis, type of surgery was the factor most associated with a lower Catquest-9SF score (β = -0.391, p<0.001).

Compared to DSBCS patients, ISBCS patients had significantly lower Catquest-9SF scores with greater visual functioning and fewer vision-related limitations in their daily activities at one month postoperatively. This difference was lost one month after the second-eye surgery in DSBCS patients. This study did not find evidence of perceived bilateral visual impairment in the early postoperative period after ISBCS.