Abstract
BackgroundThe standard approach to treat cataracts is Delayed Sequential Bilateral Cataract Surgery (DSBCS), during which patients have a separate operation date for each eye. An alternative method of delivery is Immediately Sequential Bilateral Cataract Surgery (ISBCS). The aim of this project was to examine the attitudes and beliefs of UK ophthalmologists towards ISBCS, explore their reasons to either practise or not practise ISBCS and identify barriers hindering its implementation in the UK.MethodsA questionnaire was distributed to consultant members of The Royal College of Ophthalmologists (RCOphth, UK) and collected electronically. An initial screening question in regards to prior experience with ISBCS directed the rest of the survey; participants were asked to rate the importance of several factors with regards to performing ISBCS. Free text options were also available. Descriptive analysis was subsequently performed.ResultsOf the 1357 recipients, 130 (9.6%) ophthalmologists completed the survey. Of those, 13.9% were currently performing ISBCS, 83.1% had never performed, and 3.1% had previously done so but since stopped. The main factors that acted as barriers were lack of: (1) College approval (20.5%); (2) medico-legal approval (20.2%); (3) evidence to support the use of ISBCS (16.0%); and (4) hospital approval (13.3%). Additionally, the perceived risk of complications for patients played an important role when considering ISBCS, with the risk of endophthalmitis being most feared.ConclusionsThis survey demonstrates some of the barriers that prevent ophthalmologist’s performing ISBCS in the UK. There is a need for further exploration in this field to evaluate the effect of addressing any of these concerns on the implementation of ISBCS.
Highlights
The standard approach to treat cataracts is Delayed Sequential Bilateral Cataract Surgery (DSBCS), during which patients have a separate operation date for each eye
Within the United Kingdom (UK), patients with visually significant cataracts are treated surgically, generally as a day case procedure. Patients can receive their operation state-funded via the National Health Service (NHS) or seek privately funded treatment
The questionnaire was formulated from discussions with a local advisory group and other clinical professionals who participated in the practice of Immediately Sequential Bilateral Cataract Surgery (ISBCS) within Sussex Eye Hospital
Summary
The standard approach to treat cataracts is Delayed Sequential Bilateral Cataract Surgery (DSBCS), during which patients have a separate operation date for each eye. An alternative method of delivery is Immediately Sequential Bilateral Cataract Surgery (ISBCS). Within the United Kingdom (UK), patients with visually significant cataracts are treated surgically, generally as a day case procedure Patients can receive their operation state-funded via the National Health Service (NHS) or seek privately funded treatment. Cataracts eventually occur bilaterally, and the conventional approach for treating bilateral cataracts is Delayed Sequential Bilateral Cataract Surgery (DSBCS) [1]. In this approach, the operation is performed on each eye on different days with an interval that allows surgeons to monitor the outcome in the first eye before proceeding to the second [1]. This will mean re-scrubbing and changing gloves and gowns with each eye as well as using different sterilisation cycles for instruments and implants with different batch numbers or from different manufacturers [4]
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