Comparison Of Immediate Sequential And Delayed Sequential Bilateral Cataract Surgery : Preoperative Factors And Postoperative Outcomes

The prevalence of Immediate Sequential Bilateral Cataract Surgery(ISBCS) has increased recently, but there's a lack of comparisons considering cataract grading and surgical complexity between ISBCS and Delayed Sequential Bilateral Cataract Surgery (DSBCS). We investigate ISBCS patient demographics and compare outcomes considering these factors.

Cataract surgeries performed at Seoul National University Bundang Hospital from January 1 to December 31, 2022 were reviewed.

During the observation period, we categorized cataract surgeries into three groups: Immediate Sequential Bilateral Cataract Surgery, Delayed Sequential Bilateral Cataract Surgery, and unilateral cataract surgery for analysis. We assessed medical history, preoperative visual acuity, spherical equivalent, corneal astigmatism, lens grade, preoperative biometry (including axial length and anterior chamber depth), types of intraocular lenses (IOLs), postoperative visual acuity, spherical equivalent, absolute refractive error, and complications.

In a study of 274 eyes, 123(44.9%) had Immediate Sequential Bilateral Cataract Surgery(ISBCS), while 48(17.5%) had Delayed Sequential Bilateral Cataract Surgery(DSBCS). DSBCS group had higher preoperative visual acuity (0.63±0.67 logMAR) than ISBCS (0.27±0.28 logMAR) (p<0.001). Cataract grades (Lens Opacities Classification System III) was no significant difference between two groups(p>0.05). Postoperative visual acuity and refractive error had no significant differences (p=0.16, 0.65). In low preoperative visual acuity (≥0.70 logMAR) group, postoperative visual acuity, refractive error and complications showed no significant differences(p=0.87, 0.24, 0.29 respectively).

Patients selecting ISBCS, DSBCS showed no significant differences in postoperative outcomes including visual acuity, spherical equivalent, refractive error, or complications. Even when considering patients' characteristics, ISBCS can be considered a safe option.