IMMEDIATE SEQUENTIAL BILATERAL CATARACT SURGERY AND THE RISK OF ENDOPHTHALMITIS: A LITERATURE REVIEW

In recent times the practice of immediate sequential bilateral cataract surgery (ISBCS) have been widely  adopted as common practice in many settings. The aim of this review is to examine the effect of ISBCS on the incidence of post operative endophthalmitis.

Literature review

A pubmed search was completed using the following keywords; Immediate sequential bilateral cataract surgery and endophthalmitis. 40 publications were identified which discussed the practice behind ISBCS, and on closer review of the literature 7 papers were included which directly examined the risk of development of endophthalmitis post ISBCS.

The incidence of post operative endophthamitis in unilateral cataract surgery is estimated to be less than 0.05%, as quoted in the literature. Upon review of the published literature for data on post operative endophthamitis following bilateral sequential cataract surgery the incidence varied between 0.0001% and 0.01%. A review of published cases within the last 50 years by Chen et al, examined the incidence of bilateral post operative endophthamitis which was only reported in 7 cases over that period.

Immediate sequential bilateral cataract surgery is presenting itself as a good option for patients who prefer this approach. The biggest worry amongst ophthalmic surgeons with ISBCS is the risk of post operative endophthalmitis. From examining the published literature, the incidence of post operative endophthalmitis does not to seem to be increased (0.01-0.0001%) and comparable to unilateral cataract surgery.