Visual And Refractive Outcomes Of Immediate Versus Delayed Sequential Bilateral Cataract Surgery: A Large Uk Tertiary Centre Cohort Study
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT251 | Type: Free paper | DOI: 10.82333/m9b3-1s90
Authors: Ms Amee Patel* 1 , Mr Jonathan Marler 2 , Mr Matthew Azzopardi 1 , Mr Romesh Angunawela 1 , Mr Rajesh Deshmukh 1
1Cataract Service ,Moorfields Eye Hospital,London,United Kingdom, 2Ophthalmology ,Royal Free Hospital ,London,United Kingdom
Purpose
To compare visual outcomes, refractive accuracy, and safety between immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS) in a large UK tertiary centre cohort.
Setting
High-volume UK tertiary ophthalmology hospital network comprising of 10 sites, including the principal centre and satellite units, with surgical data extracted from all locations across London.
Methods
This retrospective cohort study included adults who underwent cataract surgery in both eyes between March 2020 and November 2024 across satellite centres of a UK tertiary eye hospital. ISBCS was compared with DSBCS. Outcomes assessed at 6–8 weeks included uncorrected visual acuity (UCVA ≥6/12), refractive accuracy within ±0.5 dioptres (D), and intraoperative or postoperative complications. Outcomes were compared per eye using relative risks (RR) with 95% confidence intervals (CI). A subgroup analysis of non-complex cases was performed.
Results
A total of 1,458 patients (2,916 eyes) underwent ISBCS and 12,583 patients (25,166 eyes) underwent DSBCS. Given the large sample size, this study had >95% power to detect a 5% difference between the groups. Achievement of UCVA ≥6/12 was comparable between groups (RR 0.98, 95% CI 0.96–1.00; p = 0.06). Refractive accuracy within ±0.5 D was higher in the ISBCS group (RR 1.08, 95% CI 1.05–1.12; p < 0.001). Complications occurred in 1.95% of ISBCS eyes and 7.3% of DSBCS eyes. Subgroup analysis of non-complex DSBCS cases demonstrated no significant difference compared with ISBCS.
Conclusions
In this large real-world NHS cohort, ISBCS achieved visual outcomes comparable to DSBCS with slightly improved refractive accuracy. When appropriately selected ISBCS offers a safe, clinically effective and scalable approach. These findings support its integration into contemporary high-volume cataract practice, with potential benefits for service efficiency, patient convenience, and sustainable healthcare delivery.