Trends in immediate sequential bilateral cataract surgery in Ontario

Area of Science:

• Ophthalmology
• Health Services Research

Background:

• The adoption of immediate sequential bilateral cataract surgery (ISBCS) is increasing due to safety evidence and demand.
• Understanding the shift in cataract surgery delivery in Ontario is crucial.

Purpose of the Study:

• To determine if a paradigm shift towards ISBCS has occurred in Ontario.
• To analyze the current role and extent of ISBCS in the province.

Main Methods:

• Retrospective analysis of Ontario Health Insurance Plan (OHIP) claim data from 2016 to 2022.
• Categorization of cataract surgeries into unilateral, ISBCS, and delayed sequential bilateral cataract surgery (DSBCS).
• Examination of trends, wait times, and cost-saving estimations for ISBCS.

Main Results:

• ISBCS cases increased sixfold during the pandemic, reaching 11,876 in 2022, representing a rise from 1% to 10% of total cases.
• Unilateral and DSBCS cases decreased during the pandemic but rebounded in 2022.
• Median wait times for first and second surgeries increased; however, ISBCS potentially saved $19 million in 2022.

Conclusions:

• A significant paradigm shift favoring ISBCS has occurred in Ontario.
• ISBCS may be a viable strategy to mitigate increasing surgical wait times.
• ISBCS adoption presents an opportunity for healthcare cost savings.