Simultaneous Bilateral Cataract Surgery
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Simultaneous bilateral cataract surgery (SBCS) remains a controversial topic in most developed countries despite studies which have shown that it is both safe and effective. The term is generally applied to the act of bilateral cataract extraction with lens placement as independent operations performed sequentially on the same visit.
The procedure is also known by the following names: Immediately sequential bilateral cataract surgery
Disease Entity
Bilateral Cataract
Disease
Cataract
Etiology
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Risk Factors
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General Pathology
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Pathophysiology
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Primary prevention
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Diagnosis
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History
As with many controversial medical procedures, there are clear advantages and disadvantages of performing simultaneous bilateral cataract surgery.
Advantages: Minimizing patient visits to the surgical facility and doctor's office Faster recovery to binocular vision - particularly seen in patient's with high refractive errors Decreased cost to patient Decreased cost to the health system
Disadvantages: Risk of bilateral endophthalmitis Risk of bilateral toxic anterior shock syndrome (TASS) Unable to gain refractive insight from first eye Decreased reimbursement for physicians (in certain health systems)
Despite the known risks, many doctors have historically performed this procedure on select patients, including those with serious co-morbidities who have significant trouble getting to the operating room and/or undergoing anesthesia.
Recent improvements in cataract surgery technology and techniques have improved the complication rate of cataract surgery to the point that even the risk of bilateral same-day surgery is exceedingly low. This has led to more surgeons offering this option to their patients.
There are regional variations in how this procedure is viewed, which can be seen in the number/percentage of patients undergoing SBCS. For example, in Sweden as many as 40 percent of patients undergo SBCS, where that number is less than 1% in the United States.
Physical examination
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Signs
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Symptoms
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Clinical diagnosis
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Diagnostic procedures
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Laboratory test
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Differential diagnosis
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Management
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General treatment
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Medical therapy
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Medical follow up
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Surgery
Surgical follow up
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Complications
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Prognosis
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Additional Resources
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References
1. Arshinoff S, Bastianelli P. Incidence of postoperative endophthalmitis after immediate sequential bilateral cataract surgery. J Cataract Refract Surg 2011;37:2105-2114. 2. Olsen T. Use of fellow eye data in the calculation of intraocular lens power for the second eye. Ophthalmology 2011;118:9:1710. 3. Covert DJ, Henry CR, Koenig SB. Intraocular lens power selection in the second eye of patients undergoing bilateral, sequential cataract extraction. Ophthalmology 2010;117:1:49-54. 4. Kessel L, Andresen J, Emgaard D, Flesner P, Tendal B, Hjordal J. Immediate Sequential Bilateral Cataract Surgery: A Systemi Review and Meta-Analysis. J Ophthalmol 2015;
