Immediate Sequential vs. Delayed Sequential Bilateral Cataract Surgery: Retrospective Comparison of Postoperative...

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Comparative Effectiveness

Background:

• Bilateral cataract surgery can be performed immediately sequential (ISBCS) or delayed sequential (DSBCS).
• Understanding the comparative effectiveness of these approaches is crucial for patient outcomes and surgical planning.
• Previous studies have explored visual acuity and refractive error differences, but comprehensive comparative analyses are ongoing.

Purpose of the Study:

• To compare best-corrected visual acuity (BCVA) and refractive error (RE) between ISBCS and DSBCS.
• To determine if second-eye outcomes in DSBCS differ from first-eye outcomes.
• To assess if ISBCS is associated with increased risks compared to DSBCS.

Main Methods:

• Retrospective comparative-effectiveness study.
• Intention-to-treat analysis of 13,711 DSBCS and 3,561 ISBCS patients.
• Conditional logistic regression accounting for patient and surgeon factors.

Main Results:

• Postoperative BCVA was similar between first and second eyes in DSBCS patients.
• Emmetropia rates were comparable across both groups (61-63%).
• No statistically significant difference in BCVA or RE was found between ISBCS and DSBCS, with similar complication rates.

Conclusions:

• ISBCS is not associated with worse visual outcomes or increased complications compared to DSBCS.
• The choice between ISBCS and DSBCS may not significantly impact refractive error outcomes.
• Both surgical timing strategies appear safe and effective for bilateral cataract surgery.