Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Cochrane Corner: immediate sequential bilateral surgery versus delayed sequential bilateral surgery for cataracts

Eye volume 37, pages 2841–2843 (2023)Cite this article

Subjects

The recently published Cochrane Review by Dickman et al. evaluated safety, clinical outcomes, cost-effectiveness and patient-reported outcomes of immediate sequential bilateral cataract surgery (ISBCS) compared to delayed sequential bilateral cataract surgery (DSBCS) [1]. The primary and secondary outcomes assessed are summarised in Table 1.

Table 1 Primary and secondary outcomes of ISBCS compared to DSBCS evaluated by Dickman et al. [1].
Full size table

A total of 14 studies were included involving 276,260 patients (7384 for ISBCS and 268,876 for DSBCS); comprising two randomised controlled trials (RCTs), seven non-randomised studies (NRSs) and six economic evaluations (one study being both a NRS and an economic evaluation). The review authors concluded that there were likely no clinically important differences in outcomes between ISBCS and DSBCS, although the limited quantity and quality of evidence provided only low- to very low-certainty regarding this lack of difference for most outcomes of interest (Table 1).

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: QALY gain from ISBCS versus DSBCS (NB. estimates of the relative QoL benefits from 1st and 2nd eye vary).

References

  1. Dickman MM, Spekreijse LS, Winkens B, Schouten J, Simons RWP, Dirksen CD, et al. Immediate sequential bilateral surgery versus delayed sequential bilateral surgery for cataracts. Cochrane Database Syst Rev. 2022;4:4. https://doi.org/10.1002/14651858.CD013270.

    Article  Google Scholar 

  2. Chu CJ, Johnston RL, Buscombe C, Sallam AB, Mohamed Q, Yang YC. Risk Factors and Incidence of Macular Edema after Cataract Surgery: A Database Study of 81984 Eyes. Ophthalmology. 2016;123:316–23. https://doi.org/10.1016/j.ophtha.2015.10.001.

    Article  PubMed  Google Scholar 

  3. Han JV, Patel DV, Squirrell D, McGhee CNJ. Cystoid macular oedema following cataract surgery: A review. Clin Exp Ophthalmol. 2019;47:346–56. https://doi.org/10.1111/ceo.13513.

    Article  PubMed  Google Scholar 

  4. Malwankar J, Son H, Chang DF, Dun C, Woreta F, Prescott C, et al. Trends, Factors, and Outcomes Associated with Immediate Sequential Bilateral Cataract Surgery among Medicare Beneficiaries. Ophthalmology. 2022;129:478–87. https://doi.org/10.1016/j.ophtha.2021.12.015.

    Article  PubMed  Google Scholar 

  5. Shekhawat NS, Stock MV, Baze EF, Daly MK, Vollman DE, Lawrence MG, et al. Impact of First Eye versus Second Eye Cataract Surgery on Visual Function and Quality of Life. Ophthalmology. 2017;124:1496–503. https://doi.org/10.1016/j.ophtha.2017.04.014.

    Article  PubMed  Google Scholar 

  6. Foster A. Vision 2020: the cataract challenge. Community Eye Health. 2000;13:17–19.

    Google Scholar 

  7. Malcolm J, Leak C, Day AC, Baker H, Buchan JC. Immediate sequential bilateral cataract surgery: patient perceptions and preferences. Eye. https://doi.org/10.1038/s41433-022-02171-7 (2022).

  8. Buchan JC, Donachie PHJ, Cassels-Brown A, Liu C, Pyott A, Yip JLY, et al. The Royal College of Ophthalmologists’ National Ophthalmology Database study of cataract surgery: Report 7, immediate sequential bilateral cataract surgery in the UK: Current practice and patient selection. Eye. 2020;34:1866–74. https://doi.org/10.1038/s41433-019-0761-z.

    Article  PubMed  PubMed Central  Google Scholar 

  9. O’Brart DP, Roberts H, Naderi K, Gormley J. Economic modelling of immediately sequential bilateral cataract surgery (ISBCS) in the National Health Service based on possible improvements in surgical efficiency. BMJ Open Ophthalmol. 2020;5:e000426. https://doi.org/10.1136/bmjophth-2019-000426.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Spekreijse LS, Simons RWP, Winkens B, van den Biggelaar FJHM, Dirksen CD, Nuijts RMMA. Cost-effectiveness of immediate versus delayed sequential bilateral cataract surgery in the Netherlands (the BICAT-NL study): study design of a prospective multicenter randomised controlled trial. BMC Ophthalmol. 2020;20:257. https://doi.org/10.1186/s12886-020-01521-x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Endophthalmitis Vitrectomy Study Group. Results of the Endophthalmitis Vitrectomy Study: A Randomized Trial of Immediate Vitrectomy and of Intravenous Antibiotics for the Treatment of Postoperative Bacterial Endophthalmitis. Arch Ophthalmol. 1995;113:1479–96. https://doi.org/10.1001/archopht.1995.01100120009001.

    Article  Google Scholar 

Download references

Funding

JCB’s work with the RCOphth National Ophthalmology Database is partly supported by unrestricted grants from Alcon and Bausch and Lomb. The other authors have no funding to declare.

Author information

Authors and Affiliations

  1. Moorfields Eye Hospital, London, UK

    Peng Yong Sim, Alexander C. Day & Christopher Leak

  2. UCL Institute of Ophthalmology, London, UK

    Alexander C. Day

  3. International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK

    John C. Buchan

  4. Leeds Teaching Hospitals NHS Trust, Leeds, UK

    John C. Buchan

Authors
  1. Peng Yong Sim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexander C. Day
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christopher Leak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. John C. Buchan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

PYS and ACD were involved in the first draft of the manuscript. PYS, ACD, CL and JCB were involved in revising and critically appraising the manuscript and final approval for publication.

Corresponding author

Correspondence to Peng Yong Sim.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sim, P.Y., Day, A.C., Leak, C. et al. Cochrane Corner: immediate sequential bilateral surgery versus delayed sequential bilateral surgery for cataracts. Eye 37, 2841–2843 (2023). https://doi.org/10.1038/s41433-023-02436-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41433-023-02436-9

Search

Advanced search

Quick links