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Related Experiment Video

Updated: Oct 9, 2025

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Immediately sequential bilateral cataract surgery (ISBCS) adapted protocol during COVID-19.

Simrenjeet Sandhu¹, Daisy Liu¹, Pamela Mathura¹

¹Department of Ophthalmology, University of Alberta, Edmonton, AB.

Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie

|December 17, 2021

Summary

Implementing immediately sequential bilateral cataract surgery (ISBCS) safely increased surgical volume by 25% and reduced patient visits by 50%. This protocol resulted in zero cases of toxic anterior segment syndrome or endophthalmitis.

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Area of Science:

Ophthalmology
Surgical Quality Improvement
Public Health

Background:

Immediately sequential bilateral cataract surgery (ISBCS) offers potential benefits but requires careful implementation.
High-volume tertiary care centers face challenges in adopting new surgical protocols.

Purpose of the Study:

To outline the implementation process, challenges, and recommendations for an evidence-based ISBCS protocol.
To evaluate the safety and efficiency of ISBCS in a Canadian tertiary care setting.

Main Methods:

A quality improvement study utilizing the Model of Improvement framework.
Involved multidisciplinary teams and a thorough literature review for protocol refinement.
Implemented ISBCS for 406 patients with specific inclusion/exclusion criteria.

Main Results:

ISBCS increased surgical volume by approximately 25% and reduced patient visits by 50%.
Enhanced safety measures included double time-outs and distinct lot numbers for materials.
Zero cases of toxic anterior segment syndrome or endophthalmitis were reported.

Conclusions:

ISBCS is a safe and effective strategy to increase surgical capacity and benefit patients.
The developed protocol can serve as a model for other centers implementing ISBCS.
ISBCS is a viable option for maintaining surgical volume during periods of reduced elective procedures.