[The importance of addressing issues related to bilateral cataract surgery]

Age-related cataract, the primary cause of blindness among middle-aged and elderly populations, represents a clinical condition where the bilateral surgical strategy cannot be simplified to the superposition of two independent operations, but constitutes a systematic project targeting the reconstruction of binocular visual function. With the increasing diversity of presbyopia-correcting intraocular lenses, clinical decision-making for bilateral cataract surgery has encountered new challenges: how to formulate a reasonable bilateral cataract surgical protocol? This paper reviews the clinical trends and evaluation systems for bilateral cataract surgery, focusing on comparing the advantages and indications of symmetrical and asymmetrical IOL implantation; it also clarifies the influence of dominant eye evaluation on postoperative visual quality, and conducts an in-depth discussion on the crucial role of neuroadaptation in postoperative visual construction. This review is expected to provide a reference for the clinical practice of bilateral cataract surgery, and more high-quality evidence-based medical research is still required to guide the formulation of individualized treatment strategies in the future.