English

Abstract

BACKGROUND Immediate sequential bilateral cataract surgery (ISBCS) is the procedure in which both eyes are simultaneously operated in a single hospital visit. The onset of corona virus disease-19 (COVID-19) pandemic has raised the interest among ophthalmic surgeon in considering immediate sequential bilateral cataract surgery to reduce hospital visit of patients. This study was done to assess the intraoperative and post-operative complications and average number of hospital visits required after performing immediate sequential bilateral cataract surgery in COVID-19 pandemic. Also, the post-operative visual outcomes were evaluated. METHODS Patients with visually significant bilateral cataract with best corrected visual acuity ≤ 6/18 in better eye, axial length within range of 21 - 25 mm and age >18 years with no ocular and systemic co-morbidity were included in the study. All patients underwent immediate sequential bilateral cataract surgery from July 2020 to September 2020. Strict intraoperative protocols were followed in all cases. Intracameral injection of 0.1 ml moxifloxacin 0.5 % (vigamox / Novartis health care Pvt Ltd. Texas, USA) was given at the end of surgery in all cases. Intraoperative and post-operative complications, visual and refractive outcomes were analysed. RESULTS Sixty-four eyes of 32 patients with mean age 55 ± 2.82 years (range: 48 - 71 years) were included in the study. The mean pre-operative best corrected visual acuity was 0.64 ± 0.08 logarithm of minimum angle of resolution which improved significantly to 0.03 ± 0.03 at the end of second follow up on day 14 (P < 0.0001). The mean post-operative spherical equivalent was -0.22 ± 0.48 D. The target refraction within ± 0.50 D was achieved in 56 eyes (87.50 %) and within ± 1.0 D in all eyes. No vision threatening complications such as endophthalmitis, cystoid macular oedema, retinal detachment or corneal decompensation occurred in any of eyes. Total hospital visits were reduced to four per patients for both eye surgeries. CONCLUSIONS Immediate sequential bilateral cataract surgery may be considered as preferred practice in selected cases to reduce the risk of cross infection of COVID-19 by short hospitalization and less follow up visits. KEYWORDS Bilateral Cataract Surgery, COVID-19, Endophthalmitis