Comparative Outcomes of Immediate Versus Delayed Sequential Bilateral Cataract Surgery: A Narrative Review.

Area of Science:

• Ophthalmology
• Surgical Innovation
• Public Health

Background:

• Immediate sequential bilateral cataract surgery (ISBCS) is gaining acceptance but adoption varies.
• Delayed sequential bilateral cataract surgery (DSBCS) is the traditional approach.
• Comparative data on ISBCS vs. DSBCS is crucial for clinical policy.

Purpose of the Study:

• To provide an updated academic review of ISBCS versus DSBCS.
• To compare outcomes and safety profiles relevant to clinical decision-making.
• To inform surgical policy development regarding bilateral cataract surgery.

Main Methods:

• Narrative review utilizing a predefined electronic search strategy.
• Prioritized national registry datasets, RCTs, and high-volume cohort studies.
• Focused on safety, efficacy, and efficiency parameters.

Main Results:

• Endophthalmitis rates were low (<1/1,000) for both ISBCS and DSBCS.
• Refractive predictability and cystoid macular edema (CME) incidence were comparable.
• ISBCS showed shorter functional recovery, reduced healthcare utilization, and up to 50% lower CO2 footprint.

Conclusions:

• ISBCS is a clinically safe and system-efficient alternative to DSBCS.
• Strict aseptic protocols are essential for ISBCS safety.
• ISBCS provides significant patient, economic, and environmental benefits.