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The Royal College of Ophthalmologists’ National Ophthalmology Database Study of Cataract Surgery: Report 7, Immediate Sequential Bilateral Cataract Surgery in the Uk: Current Practice and Patient Selection Publisher Pubmed



Buchan JC1, 2 ; Donachie PHJ3, 4 ; Casselsbrown A5, 6 ; Liu C7 ; Pyott A6 ; Yip JLY1 ; Zareighanavati M8 ; Sparrow JM3, 9
Authors
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Authors Affiliations
  1. 1. International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
  2. 2. Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, United Kingdom
  3. 3. The Royal College of Ophthalmologists’ National Ophthalmology Audit, 18 Stephenson Way, London, NW1 2HD, United Kingdom
  4. 4. Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, GL53 7AN, United Kingdom
  5. 5. Centre for Sustainable Healthcare, Oxford, OX2 7JQ, United Kingdom
  6. 6. NHS Highland, Inverness, IV2 7GE, United Kingdom
  7. 7. Tongdean Eye Clinic. Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton and Sussex Medical School, Eastern Road, Brighton, BN2 5BF, United Kingdom
  8. 8. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Bristol Eye Hospital, Lower Maudlin Street, Bristol, BS1 2LX, United Kingdom

Source: Eye (Basingstoke) Published:2020


Abstract

Background: Cataract extraction is the most frequently performed surgical intervention in the world and demand is rising due to an ageing demography. One option to address this challenge is to offer selected patients immediate sequential bilateral cataract surgery (ISBCS). This study aims to investigate patient and operative characteristics for ISBCS and delayed bilateral cataract surgery (DSCS) in the UK. Methods: Data were analysed from the Royal College of Ophthalmologists’ National Ophthalmology Database Audit (NOD) of cataract surgery. Eligible patients were those undergoing bilateral cataract extraction from centres with a record of at least one ISBCS operation between 01/04/2010 and 31/08/2018. Variable frequency comparison was undertaken with chi-square tests. Results: During the study period, 1073 patients had ISBCS and 248,341 DSCS from 73 centres. A higher proportion of ISBCS patients were unable to lie flat (11.3% vs. 1.8%; p ' 0.001), unable to cooperate (9.7% vs. 2.7%; p ' 0.001); underwent general anaesthesia (58.7% vs. 6.6% (p ' 0.001)); had brunescent/white/mature cataracts (odds ratio (OR) 5.118); no fundal view/vitreous opacities (OR 8.381); had worse pre-operative acuity 0.60 LogMAR ISBCS vs. 0.50 (first) and 0.40 (second eye) DSCS and were younger (mean ages, 71.5 vs. 75.6 years; p ' 0.001). Posterior capsular rupture (PCR) rates adjusted for case complexity were comparable (0.98% ISBCS and 0.78% DSCS). Conclusions: ISBCS was performed on younger patients, with difficulty cooperating and lying flat, worse pre-operative vision, higher rates of known PCR risk factors and more frequent use of general anaesthesia than DSCS in centres recorded on NOD. © 2020, The Author(s), under exclusive licence to The Royal College of Ophthalmologists.
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3. The Uptake of Immediately Sequential Bilateral Cataract Surgery in Different Parts of the World, Immediately Sequential Bilateral Cataract Surgery (ISBCS): Global History and Methodology (2022)
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