Safety and Efficacy of Immediately Sequential Versus Delayed Sequential Bilateral Cataract Surgery
At multiple clinics on the Canary Islands in Spain, researchers performed a multi-center, randomized clinical trial to assess the safety and effectiveness of immediately sequential bilateral cataract surgery (ISBCS) versus delayed sequential bilateral cataract surgery (DSBCS).
They randomized patients with cataracts requiring bilateral surgery to ISBCS or DSBCS. Outcome measures were the incidence of intraoperative and postoperative surgical complications, corrected and uncorrected visual acuities and self-perceived visual function (VF-14 questionnaire). The researchers measured all outcomes 30 days postoperatively and assessed self-perceived visual function after one year. They analyzed data with repeated measures to assess temporal effects on surgical complications, visual acuity and function and also estimated effect size for self-perceived visual function.
The researchers found no differences in intraoperative or postoperative surgical complications, visual acuity 30 days postoperatively or self-perceived visual function after one year between the two techniques. They noted that effect size for visual function 30 days postoperatively was moderate in the ISBCS group (n=834) and small in the DSBCS group (n=780). This difference disappeared at one-year follow-up after second-eye surgery in the delayed group.
There were no relevant surgical complications in 1,614 operated eyes and no significant difference in surgical complications, visual acuity or long-term, self-perceived visual function between ISBCS and DSBCS, the researchers reported. They related these safety and effectiveness outcomes to careful patient selection, surgical expertise and the systematic use of standardized surgical guidelines to ensure aseptic and independent surgery in each eye.