Outcomes Of Immediate Sequential Bilateral Cataract Surgery At A Single Centre In North West London

Immediate Sequential Bilateral Cataract Surgery (ISBCS) is increasingly performed in the UK with aims to improve patient flow and experience. However, adoption within the NHS setting is not yet widespread. This study aims to evaluate the visual and refractive outcomes of ISBCS in an NHS hospital in the UK.

The study was carried out at Hillingdon Hospital in North West London, UK.

A retrospective review of patients who underwent ISBCS by a single surgeon between January 2021 and February 2026 was performed. Data on demographics and ocular and systemic comorbidities were obtained from electronic medical records. Perioperative factors, including anaesthesia, use of augmentation (e.g vision blue, iris hooks or capsular tension ring), and intra- and post-operative complications, were also recorded. Best-corrected visual acuity (BCVA) and spherical equivalent (SE) were obtained pre-operatively and post-operatively from hospital and community optician records.

26 patients underwent ISBCS with a mean age of 73.6 years; 54% were male, 19% were diabetic, and 65% were White British. Main indications for ISBCS were patient wishes (77%), learning difficulty (15%) and dementia (8%).

55% of cases were performed topically, and 81% did not require augmentation. 3 eyes had complications – 1 anterior capsular tear, 1 posterior capsule rupture with zonular dialysis and 1 post-operative corneal oedema.

The mean pre-operative BCVA was LogMAR 0.54, with 91% of eyes gaining a mean of LogMAR 0.40 post-operatively. The most common formulas for intraocular lens selection were SRK/T (69%), then Barrett (25%) and Hoffer-Q (6%). 89% of eyes achieved within ±1D of the predicted post-operative outcome.

These findings support the use of ISBCS as an effective and safe option within an NHS setting. In vulnerable patients, there are additional benefits in reducing repeated exposure to general anaesthesia and visits to the hospital.