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Characteristics of immediate sequential bilateral cataract surgery.

Chaerim Kang1, Angela S Zhu, Michael Kashner

  • 1From the Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island (Kang, Greenberg); Section of Ophthalmology, VA Providence Healthcare System, Providence, Rhode Island (Kang, Greenberg); Department of Ophthalmology and Visual Sciences, University of Maryland Medical Center, Baltimore, Maryland (Zhu); Office of Academic Affiliations, Department of Veterans Affairs, Washington, District of Columbia (Kashner); Section of Ophthalmology, VA Iowa City Healthcare System, Iowa City, Iowa (Oetting); Section of Ophthalmology, VA Manchester Healthcare System, Manchester, New Hampshire (Morhun).

Journal of Cataract and Refractive Surgery
|December 15, 2025
PubMed
Summary

Immediate sequential bilateral cataract surgery (ISBCS) offers similar safety outcomes to delayed surgery (DSBCS). This study found no significant difference in postoperative complications between ISBCS and DSBCS in U.S. veterans.

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Area of Science:

  • Ophthalmology
  • Surgical Outcomes
  • Public Health

Background:

  • Cataract surgery is a common procedure.
  • Sequential bilateral cataract surgery can be performed immediately or delayed.
  • Patient and center characteristics may influence the choice between immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS).

Purpose of the Study:

  • To compare the characteristics and surgical outcomes of ISBCS versus DSBCS.
  • To evaluate the safety and efficiency of ISBCS within the U.S. Department of Veterans Affairs healthcare system.

Main Methods:

  • Retrospective study of 47,892 patients undergoing bilateral cataract surgery between 2004 and 2024.
  • Comparison of patient demographics, comorbidities, travel burden, center volume, and surgeon type between ISBCS and DSBCS groups.
  • Analysis of postoperative complication rates for both surgical approaches.

Main Results:

  • ISBCS was performed in 2.4% of bilateral surgeries.
  • ISBCS patients had a greater travel burden and fewer ocular comorbidities but similar age, sex distribution, and Charlson Comorbidity Index compared to DSBCS patients.
  • ISBCS was more frequent at high-volume centers and less common with resident surgeons; complication rates were not significantly different between groups.

Conclusions:

  • Immediate sequential bilateral cataract surgery is a safe alternative to delayed surgery with comparable postoperative complication rates.
  • Patient selection for ISBCS may be influenced by factors such as travel burden and ocular comorbidity status.
  • ISBCS is more prevalent in high-volume centers, suggesting potential benefits in efficiency or resource allocation.