Refractive outcomes and safety profile after sequential bilateral cataract surgery

To evaluate the safety and effectiveness of simultaneous bilateral cataract surgery (SBCS) in a private ophthalmology clinic, focusing on postoperative refractive outcomes, visual acuity, and the incidence of complications.

This observational, retrospective study included 200 eyes from 100 patients who underwent SBCS between January 2018 and April 2020. Preoperative evaluations comprised visual acuity, refraction, biometry, and anterior segment examinations. Surgeries were performed sequentially by a single surgeon using femtosecond laser-assisted or stop-and-chop techniques, with adherence to iSBCS guidelines. Postoperative care included topical antibiotics and steroids, with follow-up at one day and four weeks. Safety outcomes included the incidence of complications, particularly Toxic Anterior Segment Syndrome (TASS), while effectiveness was assessed by postoperative visual acuity and refraction.

Postoperative complications were observed in 2.5% of cases, including two cases of unilateral TASS, one case of corneal edema, one reactivation of diabetic macular edema, and one of ocular hypertension. All complications were resolved with medical management, and no cases of endophthalmitis were reported. Visual acuity improved significantly, with all eyes achieving 0.096 logMAR or better by week four. Refractive outcomes showed high accuracy, with no significant refractive surprises.

SBCS is a safe and effective procedure, delivering excellent visual and refractive outcomes. The incidence of complications, including TASS, was low, and all cases were successfully managed. This approach can be a viable alternative for patients with bilateral cataracts, particularly in settings with strict adherence to sterilization and surgical protocols.