Bilateral Cataract Surgery Research Articles

Catquest-9SF questionnaire shows greater visual functioning in bilateral cataract populations: A prospective study.

Visual functioning evaluated by the Catquest-9SF questionnaire has shown to be a valid measure for assessing a patient's prioritization for cataract surgery. This study adapted Catquest-9SF for visual function outcomes post uni-lateral cataract surgery or bi-lateral cataract surgery. Visual functioning was assessed before and after uni-lateral or bi-lateral cataract surgery using the Catquest-9SF questionnaire. Patients were enrolled to this study prior to their cataract surgery between March 29 and April 30, 2021 at Shellharbour Hospital, Australia. Catquest-9SF questionnaires were completed prior to and 3 months post surgery. Resulting data were assessed for fit to a Rasch model using WINSTEPS software (version 4.2.0). Catquest-9SF data analysis of Chi-square, Wilcoxon sum test, and Fischer's test were performed in R (version 4.1.0). P value <.05 was considered statistically significant. Sixty-one patients (mean age = 73.2 years, 62% female) were included for analysis. Catquest-9SF response thresholds, adequate precision (person separation index = 2.58, person reliability = 0.87, Cronbach's alpha = 0.74), uni-dimensionality, and no misfits (infit range 0.65-1.33; outfit range 0.64-1.31) were recorded. The mean of item calibration for patients was -0.22 post-operatively. There was significant (P <.05) improvement (16.3%) in visual functions across all nine Catquest 9-SF items. There was a significant mean visual function difference between patients with uni-lateral (10.1%) and bi-lateral cataract surgery (22.3%) pre-operatively and post-operatively. The Catquest-9SF questionnaire showed excellent psychometric properties and can assess visual functioning in an Australian population. There was a significant improvement in patient visual function post cataract surgery and higher functioning with bi-lateral cataract surgery.

Visual recovery after immediate sequential bilateral cataract surgery at a veterans' hospital.

To answer patient questions about the expected timeline for recovery, the objective postoperative visual acuities were reviewed for patients undergoing immediate sequential bilateral cataract surgery (ISBCS). Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri. Retrospective chart review. All patients who underwent ISBCS in 2019 were evaluated. A total of 116 patients (232 eyes) were studied. Uncorrected distance visual acuity (UDVA) for postoperative day 0 or 1 (POD0/1), postoperative week 1 (POW1), and postoperative month 1 (POM1) were required for study inclusion. Patients with ocular comorbidities were not excluded, although all patients passed an initial screening to qualify for ISBCS. The outcome measures included POD0/1, POW1, and POM1 UDVA. Postoperative UDVA was stable or improved compared with preoperative corrected distance visual acuity (CDVA) for 48% (66/138) of eyes on POD0, 79% (74/94) of eyes on POD1, and 90% (209/232) of eyes on POW1. 83% of patients at POD1 and 90% of patients at POW1 had stable or improved visual acuity in at least 1 eye. 92% (214/232) of eyes had a POW1 UDVA of 20/40 or better. Of the 18 eyes with a postoperative POW1 UDVA of 20/50 or worse, 5 (28%) were known preoperatively to have limited visual potential. 99% (115/116) of patients had at least 1 eye 20/40 or better. Most of the patients who underwent ISBCS demonstrated meaningful improvement in UDVA compared with preoperative CDVA as early as POD1. These results serve to guide discussion of postoperative expectations with patients interested in ISBCS.

How does immediate sequential bilateral cataract surgery (ISBCS) compare with delayed sequential bilateral cataract surgery (DSBCS) for people with cataracts?

How does immediate sequential bilateral cataract surgery (ISBCS) compare with delayed sequential bilateral cataract surgery (DSBCS) for people with cataracts?

Immediate sequential bilateral cataract surgery: a 13-year real-life report of 56 700 cataract operations

Background/aimsTo assess the frequency of immediate sequential bilateral cataract surgery (ISBCS) and endophthalmitis during 13-year period in Tays Eye Centre, Tampere University Hospital, Tampere, Finland.MethodsAll cataract surgeries performed between 1...

Comparative Assessment of the Dynamics of Visual Performance of a Patient with Visually Intense Work with Binocular Cataract after Various Technologies of Cataract Phacoemulsification

Purpose. Comparative assessment of the dynamics of visual performance (VP) of a patient with visually intense work with binocular cataract after various technologies of cataract phacoemulsification (PEC).Methods. There were 300 patients with binocular cataract under our observation. Patients were divided into three equals in number (n = 100), age (from 38 to 66 years, mean age 55.8 ± 1.3 years), gender (78 % — men; 22 % — women), refractive values of the group who underwent PEС using the following technologies: delayed sequential bilateral cataract surgery (DSBCS), immediate sequential bilateral cataract surgery according to the traditional (trISBCS) and developed algorithms (maISBCS). Examination of the state of vision of patients in all groups was performed before and 3 months after surgery according to clinical (BCVA in terms of the difference between the first and second eye) and the following ophthalmo-ergonomic indicators, which were assessed using special computer programs: “Visual productivity”, “Glazomer”, “Visual search”.Results. Differences between the clinical outcomes of the first and second eyes with maISBCS and DSBCS are practically insignificant (UDVA within 0.02 rel. units), after trISBCS they are statistically significant (by 0.08–0.09 rel. units, p < 0.05). After the operation, a pronounced (p < 0.001) increase in VP was noted in all groups. At the same time, there were differences between the groups of patients who underwent maISBCS and trISBCS, manifested by a decrease in VP in the trISBCS group according to the “Visual Search” and “Eye Meter” tests, by 16.1–22.1 % (p < 0.05).Conclusion. The postoperative level of VR achieved during maISBCS and and DSBCS is almost identical. It has been determined that with an increase in the level of complexity of the ophthalmo-ergonomic tests presented (“signal-response”; “selection of a signal from several — response”; “selection of a signal in conditions of time pressure”), there is a corresponding increase in the difference in the level of SR between groups of patients who were maISBCS and trISBCS, were performed (by 1.5 %, p > 0.05; 16.1 %, p < 0.05; and 22.1 %, p < 0.05, respectively), which may be associated with the occurrence of postoperative anisometropia.

A rare case in a child with mild trichothiodystrophy associated with ERCC2 gene

A 7-year-old girl with bilateral cataracts, along with photosensitivity, was suspected to have xeroderma pigmentosum. Further dermatological examination confirmed the proband had dry skin, brittle hair, high-arched palate, and ichthyosis. The proband underwent bilateral cataract surgery. Her best corrected visual acuity (BCVA) improved to 6/9 in both eyes. Polarizing light microscopic observation of the proband eyebrow hair shaft resembled tiger tail-like stripes, which is an authentic clinical feature associated with trichothiodystrophy (TTD). Furthermore, on whole exome sequencing (WES) of the proband, mutations in the ERCC2 gene were found to be strongly associated with TTD1.

Surgical interventions for bilateral congenital cataract in children aged two years and under.

Surgical interventions for bilateral congenital cataract in children aged two years and under.

Cost-Effectiveness of Presbyopia Correction Among Seven Strategies of Bilateral Cataract Surgery Based on a Prospective Single-Blind Two-Center Trial in China.

The aim of this study was to explore a method to rank the cost-effectiveness of presbyopia correction in diverse strategies of bilateral cataract surgery to provide references for healthcare policymakers in rationalizing resource utilization and surgeons in customizing patient management. The cost-effectiveness analysis based on a prospective single-blind two-center clinical trial included seven strategies in bilateral cataract surgery: monofocal, monovision, diffractive bifocal, blended, refractive bifocal, trifocal, and extended depth of focus (EDOF) strategies. The effectiveness according to the objective spectacle independence rate (hereafter "rate", a novel indicator defined as the proportion of patients with binocular uncorrected distance, intermediate and near visual acuity all better than 0.1logMAR, logarithm of the minimum angle of resolution), costs, average cost-effectiveness ratios (ACERs, $/1% rate), and incremental cost-effectiveness ratios (ICERs, $/1% incremental rate) were estimated. In 194 participants (388 eyes), the trifocal strategy achieved the highest rate [93.10% (95% confidence interval (CI) 83.8-102.35%)]. The refractive bifocal strategy had the minimum ACER [$45.54/1% rate (95%CI 34.57-56.50)], followed by the blended [$59.10/1% rate (95%CI 31.72-86.48)], diffractive bifocal [$69.06/1% rate (95%CI 30.89-107.21)], EDOF [$72.85/1% rate (95%CI 52.02-93.70)], trifocal [$93.01/1% rate (95%CI 83.23-102.79)], monovision [$136.83/1% rate (95%CI - 55.40 to 329.14)], and monofocal [$264.45/1% rate (95%CI - 97.45 to 626.55)] strategies. Compared with the refractive bifocal strategy, the probabilities that the trifocal strategy (ICER $289.74/1% incremental rate) is very cost-effective and cost-effective were 81.7% and 93.2%, respectively, at the wiliness-to-pay threshold of one and three times China's annual disposable income per capita in 2021 per 10% incremental rates. Cost-effectiveness analysis with ACER and ICER according to objective spectacle independence rate is a helpful tool to identify highly cost-effective presbyopia-correcting strategies in cataract surgery for clinical and policy decisions. Clinicaltrials.gov (NCT04265846).

Immediate Sequential Bilateral Cataract Surgery: Opinions among Refractive Surgeons in the United States and a Comparative Analysis with European Consultants.

Purpose To analyze the perspectives of practicing refractive surgeons regarding the implementation of Immediate Sequential Bilateral Cataract Surgery (ISBCS) in the United States (US) and to compare their perspectives with those of European colleagues. Setting. Online refractive surgery forum. Design A survey-based questionnaire. Methods An electronic survey was emailed to all surgeon members of the Refractive Surgery Alliance (RSA) in the US. Participants were prompted to score their impressions regarding various aspects regarding ISBCS. Responses were compared to published reports conducted among European surgeons. Results The electronic link to the survey was emailed to US-based surgeon members of the RSA, where 107 participated (44.6%). Twenty-seven (25.2%) reported that they currently perform ISBCS. Twenty-three (22.5%) of the respondents indicated they felt ISCBCS should be offered as a standard of care for routine cataract surgery. For surgeons that do not perform ISBCS, the most important factors were related to medicolegal issues and decreased reimbursement, whereas evidence of effectiveness and complications related to ISBCS were less important. Compared to practitioners abroad, 67.2% of European ophthalmic surgeons, compared to 25.2% of US surgeons, perform ISBCS (p < 0.0001). Conclusions While US refractive surgeons often perform bilateral corneal procedures, many significant barriers exist to the widespread adoption of ISBCS. Concerns reported by US surgeons mirror those reported by surgeons in Europe. The majority of the US refractive surgeons in this survey indicate that ISBCS should not be the standard of care in routine cases, with the prevailing reason being concerns about decreased physician reimbursement and potential medicolegal issues, not safety.

Visual outcomes of non-diffractive extended-depth-of-focus and enhanced monofocal intraocular lenses: A case-control study.

To compare the visual outcomes of a non-diffractive extended-depth-of-focus (EDoF) intraocular lens (IOL) with an enhanced monofocal IOL. We evaluated 76 eyes from 38 patients who had undergone bilateral cataract surgery with implantation of either an EDoF IOL (AcrySof IQ Vivity, n = 40 eyes) or an enhanced monofocal IOL (Tecnis Eyhance, n = 36 eyes). Objective refraction, monocular and binocular uncorrected and corrected distance visual acuity (UDVA, CDVA), uncorrected and distance-corrected intermediate visual acuity (UIVA, DCIVA), uncorrected and distance-corrected near visual acuity (UNVA, DCNVA), binocular defocus curves, contrast sensitivity, halo and glare perception, and spectacle independence were compared. Monocular and binocular UDVA, CDVA, UIVA, and DCIVA were comparable in both groups, whereas UNVA and DCNVA were significantly better with the Vivity group than with the Eyhance group. The two groups had no statistically significant difference regarding photopic and scotopic contrast sensitivities or halo and glare perception. Compared to the Eyhance IOL, the Vivity IOL had a larger landing zone in the defocus curve and provided higher spectacle independence for near vision. Both the AcrySof IQ Vivity and Tecnis Eyhance IOLs had excellent distant and intermediate visual acuity, while the former had more satisfactory near vision outcomes with greater spectacle independence rate. No differences were obtained between two IOLs in terms of patient satisfaction and visual disturbances such as halo and glare.

Developing the technology of immediate sequential bilateral cataract surgery and assessing its clinical effectiveness

Objective: development of the technology of immediate sequential bilateral cataract surgery (ISВCS) and assessment of its clinical effectiveness. Materials and Methods. Our study was conducted in two stages. At stage I, we reviewed the published materials on traditional algorithm of conducting ISВCS, as a result of which, a modified algorithm for performing surgical intervention (mоISBCS) was developed. At stage II, 130 patients (mean age of 58.4±1.8 years) with uncomplicated binocular cataract were under observation. Patients were divided into two groups of similar age and eye condition. The main group included 67 people (134 eyes), who underwent mоISBCS. The control group comprised 63 subjects (126 eyes), who underwent surgery on the second eye (delayed sequential bilateral cataract surgery, DSВCS) 21–28 days after the first operation. Results. The analysis of traditional provisions served the basis for improving ISВCS technology by including a long (at least 60 min) pause between operations with a comprehensive examination of the patient in the algorithm of surgical intervention. The obtained data demonstrated similar clinical effectiveness of mоISBCS and DSВCS. Conclusion. The mоISBCS technology can be considered an effective and safe method of cataract surgical treatment, which is especially important for patients with occupation yielding a visual stress.

Comparative study of the clinical outcomes of immediate sequential bilateral cataract surgery and delayed sequential bilateral cataract surgery

BACKGROUND: In the last decade, the number of randomized controlled trials indicating the safety and efficacy of immediate sequential bilateral cataract surgery (ISBCS) comparable to the results of delayed sequential bilateral cataract surgery (DSBCS) has been increasing. However, these studies are practically absent in the practice of domestic ophthalmology.&#x0D; AIM: To comparatively assess the clinical results of ISBCS and DSBCS.&#x0D; METHODS: Our observation revealed that 1000 patients (2000 eyes) with binocular cataracts aged 3768 years (mean age: 56.91.3 years), including 82% of males and 18% of females. Patients were divided into two groups: the main group (500 patients, 1000 eyes), who underwent ISBCS according to the developed modified algorithm (ma ISBCS), and the control group (500 patients, 1000 eyes), who underwent DSBCS technology with a break after the first surgical intervention 710 days. The study was conducted from January 2017 to September 2021. All patients were operated on by one surgeon. The following monofocal intraocular lenses (IOLs) were implanted to correct aphakia: Acrysof Natural IQ (Alcon, USA), Akreos AO (Bausch Lomb, USA), and Biflex (Medicontur, Hungary). Biometrics and IOL calculation were performed using an optical biometer IOL Master (Zeiss, Germany). The following clinical efficacy criteria were assessed (before and 3 months postoperatively): the presence of intra- and postoperative complications, measurement of the maximum correctable distance visual acuity (BCVA), and deviation from the target (0.5 D) refraction.&#x0D; RESULTS: maISBCS provides almost identical (with DSBCS) clinical results of surgical intervention, which is confirmed by the minimum (0.1%0.6%, n=1000) level of postoperative complications (in the absence of endophthalmitis), the average values of BCVA (0.940.02; 0.950.02, p=0.724) and target refraction (0.300.05; 0.280.04, p=0.723), achieving BCVA of 1.0 rel unit (87%88% of cases), and emmetropic refraction (28%29% of cases).&#x0D; CONCLUSION: maISBCS is a promising direction in cataract surgery, especially considering the established (compared to DSBCS) advantages associated with higher efficiency in terms of anisometropia development and the priority of performing in a difficult epidemiological environment, as well as a significant reduction in the financial costs of surgery.

Сравнительная оценка клинико-экономической эффективности немедленной последовательной двусторонней хирургии катаракты и отсроченной последовательной двусторонней хирургии катаракты

Рurpose. Comparative evaluation (from the standpoint of the Compulsory Medical Insurance Fund, CHI) of the clinical and economic efficiency of immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS). Material and methods. The assessment was based on the calculation of direct medical and indirect costs of the operation. The cost of preoperative preparation in accordance with the rules of hospitalization in the surgical department was calculated on the basis of compulsory medical insurance rates for 2022. Results. The total costs (from the perspective of the compulsory health insurance fund) during the implementation of the DSBCS are 44.2 % higher than in the case of the ISBCS, which is generally consistent with the alternative calculations made in other countries (Finland, USA, Canada). Conclusion. The leading factor in the introduction of ISBCS into wide clinical practice is the development of a technology that provides comparable (with DSBCS) clinical results in terms of the level of intra and postoperative complications (especially endophthalmitis), the achieved values of BCVA, refraction of the “goal” and “quality of life” of the patient. In this case, ISBCS is characterized (compared with DSBCS) by a number of significant advantages associated with faster recovery of binocular vision, the possibility of surgical treatment of cataracts in a difficult epidemiological environment (reducing the use of personal protective equipment, minimizing repeated visits), more efficient workload in the operating room and less treatment costs from the standpoint of the state and the patient. Keywords: cataract phacoemulsification, medical expenses for treatment, compulsory medical insurance fund.

Prevalence and Risk Factors of Glaucoma Following Pediatric Cataract Surgery with Primary Implantation in Tertiary Eye Hospital, Bangladesh

Background: Glaucoma is a typical side effect of juvenile cataract surgery. According to various research, it seems to have a bimodal occurrence. In Bangladesh, these difficulties constitute a hardship. Objective: In this study our main aim is to evaluate the prevalence and Risk Factors of Glaucoma Following Pediatric Cataract Surgery with Primary Implantation in Tertiary Eye Hospital. Method: This cross-sectional study was carried out at tertiary eye hospital, Bangladesh from August 2021 to June 2022. Where a total of 200 children who underwent unilateral or bilateral cataract surgery with primary IOL implantation in the first year of their life. All eyes presenting with an isolated cataract or an anterior form of persistence of fetal vasculature not requiring posterior vitrectomy or a moderate microphthalmia allowing primary IOL implantation and with a follow-up of &gt;1year were included in the study. Results: During the study, 70% were female and majority were belong to 7-12 years age group, 55%. According to Intraoperative, and Postoperative Characteristics of study group where bilateral cataract was seen in 45% cases followed by 49% cases were capsular bag, 37% cases were sulcus, 46% used trypan bag. Comparing the SG group to the group that did not develop glaucoma, follow-up time was longer (mean 7,5 vs 5.6 years, P&lt;.001), age at surgery was lower (mean 4 vs 5.0 years; P¼.045), reintervention was more frequent (P&lt;.001), and trypan blue was used more frequently (P¼.008). In univariate analysis, the following factors were significantly associated with an increased risk of SG: axial length&lt;16.5 mm, bilateral cataract, perioperative use of trypan blue, additional surgical procedures, and younger age at surgery. Conclusion: We may infer that the risk of SG increases with time, and that SG appears to have a bimodal occurrence, with an estimated linear incidence rate each year. Follow-up should begin quickly after surgery and last for a long time, and clinicians ......

Association of Blue Light–Filtering Intraocular Lenses With All-Cause and Traffic Accident–Related Injuries Among Patients Undergoing Bilateral Cataract Surgery in Finland

Blue light-filtering (BLF) intraocular lenses (IOLs) have been widely used in clinical practice for more than 20 years and have been implanted in millions of patients with cataracts worldwide. However, little evidence on the association of BLF IOLs with injuries is available. To assess the association of BLF IOLs with all-cause and traffic accident-related injuries and quality of vision while driving after bilateral cataract surgery. This retrospective registry-based cohort study included patients who underwent bilateral cataract surgery between September 3, 2007, and December 14, 2018, and were followed until December 14, 2021. Surgery was performed at the Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland. The 4986 participants received non-BLF IOLs (n = 2609) or BLF IOLs (n = 2377) in both eyes. Patients undergoing bilateral surgery between 2015 to 2016 with non-BLF IOLs (n = 102) or BLF IOLs (n = 91) and currently driving a car were interviewed using a structured questionnaire for visual performance while driving. Follow-up for a mean (SD) of 2166 (1110) days after second eye surgery. Kaplan-Meier and multivariable Cox proportional hazards regression analyses for the risk of all-cause and traffic accident-related injuries after surgery in the second eye obtained from the patient medical records were assessed. To improve follow-up precision, both death and the end of the follow-up were used as censoring events. A total of 4986 patients were included in the analysis (1707 [34.2%] men and 3279 [65.8%] women; mean [SD] age, 73.2 [8.6] years at the first surgery and 74.3 [8.8] years at the second). Injury-free survival rates preceding the first eye surgery were comparable between the non-BLF and BLF IOL groups (hazard ratio adjusted for age and sex, 0.95 [95% CI, 0.81-1.13; P = .57]). In multivariable Cox proportional hazards regression analysis controlling for age and sex, the use of BLF IOLs showed no advantage in overall injuries compared with the use of non-BLF IOLs (hazard ratio, 0.99 [95% CI, 0.88-1.11]; P = .85) or in any injury subtype. Subjective visual performance parameters for driving were all comparable between the non-BLF and BLF IOL groups except for glare when driving in the dark (evening or night), which occurred among 9 of 80 patients with BLF IOLs compared with 0 of 83 non-BLF IOLs (P < .001). The findings of this cohort study suggest that use of BLF IOLs was not associated with reduced risk of injuries, whereas glare during nighttime driving was significantly worse in the BLF IOL group with pseudophakia.

Comparison of Formula-Specific Factors and Artificial Intelligence Formulas with Axial Length Adjustments in Bilateral Cataract Patients with Long Axial Length.

IntroductionTo evaluate and compare the effectiveness for reducing the prediction error (PE) of the second eye using formula-specific factors, artificial intelligence (AI) formulas (PEARL-DGS and Kane), and the Cooke-modified axial length (CMAL) methods in bilateral cataract patients with long axial length (AL).MethodsA total of 98 patients with long AL who underwent sequential bilateral cataract surgeries were retrospectively enrolled. The second-eye IOL power was calculated by the formula-specific factors, AI formulas, and CMAL methods when the first eye suffered from refraction surprise. The correction factors of eight formulas were calculated by regression analysis.ResultsThere was a significant correlation between bilateral preoperative biometric parameters (P < 0.05) as well as bilateral PE (P < 0.05). The Kane formula displayed the lowest median absolute error (MedAE) and highest proportion of PE within ± 0.50 and ± 1.00 D compared with other formulas for the first eye. For the second-eye refinement, all three methods could reduce the second-eye MedAE. The formula-specific correction factors were 0.250, 0.331, 0.343, 0.394, 0.409, 0.452, 0.503, and 0.520 for Kane, Barrett Universal II (BUII), PEARL-DGS, Holladay 2, Holladay 1, Haigis, Hoffer Q, and SRK/T, respectively. The new AI-based Kane and PEARL-DGS with or without the CMAL methods could improve the refractive outcomes of the second eye in sequential bilateral cataract patients with long AL. The Kane, BUII, and PEARL-DGS with specific correction factors displayed higher accuracy compared with the other two methods (P < 0.05).ConclusionsThe new AI-based Kane and PEARL-DGS with or without the CMAL methods could improve the refractive outcomes of the second eye in sequential bilateral cataract patients with long AL. Notably, the Kane, PEARL-DGS, and BUII with specific correction factors displayed higher accuracy.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40123-022-00551-6.

Outcomes of bilateral cataract surgery in children 7 to 18 years of age: a comparison to younger cohorts

Outcomes of bilateral cataract surgery in children 7 to 18 years of age: a comparison to younger cohorts

Bilateral posterior scleritis after sequential bilateral cataract surgery: a case report

BackgroundPosterior scleritis is a rare, inflammatory ophthalmic disease, leading to severe visual impairment if untreated. Posterior scleritis occurring after surgery, unrelated to systemic inflammatory diseases, is even rarer. This report discusses a case of bilateral posterior scleritis, after cataract surgery in both the eyes, treated with high-dose steroids.Case presentationA 55-year-old man, who had undergone bilateral sequential cataract surgery one week before, presented with sudden loss of vision and ocular pain in both eyes. The patient had no systemic diseases or neurological symptoms. Serous retinal detachment of the macula with optic disc swelling was observed on fundus examination in both the eyes, and bilateral thickening of choroid and sclera was seen in ultrasonography. Under diagnosis of bilateral posterior scleritis due to the increased signal of sclera in both the eyes on magnetic resonance imaging, high-dose steroid therapy was performed. After treatment, improvement in visual acuity and retinal detachment were observed, and thereafter, it has been maintained without relapse.ConclusionsWith high-dose steroid therapy, we successfully treated a rare case of bilateral posterior scleritis following cataract surgery in both eyes. To our knowledge, this is the first report on posterior scleritis occurring after surgery, unrelated to systemic inflammatory diseases.

Immediate sequential bilateral cataract surgery: patient perceptions and preferences.

BackgroundRecent national data suggests that less than 0.5% of NHS cataract patients undergo immediate sequential bilateral cataract surgery (ISBCS). Since ISBCS improves service efficiency, increasing its practice may help tackle the ever-growing burden of cataract in the UK, and reduce the COVID-19 cataract backlog. Surgeon attitudes are known to be a significant barrier to increasing the practice of ISBCS. However, little is known about patient perceptions of ISBCS.MethodsPatients at cataract clinics across three NHS hospital sites were recruited to complete an investigator-led structured questionnaire. Open-ended and closed-ended questions were used to assess awareness of ISBCS, willingness to undergo ISBCS and attitudes towards ISBCS.ResultsQuestionnaires were completed by 183 patients. Mean participant age was 70.5 (9.9) years and 58% were female. Forty-three percent were aware of ISBCS, chiefly via clinic staff. Just over a third would choose ISBCS if given the choice, and participants that perceived they were recommended ISBCS were more likely to opt for it. The most common motivator and barrier to uptake of ISBCS was convenience and the perceived risk of complications in both eyes respectively. Concerns related to the recovery period were common, including misunderstandings, such as the need to wear eye patches that obscure both eyes.ConclusionsOur study indicates that significantly more NHS patients would be willing to undergo ISBCS if given the choice. The reluctance of surgeons to recommend ISBCS and patient misunderstandings regarding the recovery period may be limiting its uptake.

Management of cataract surgery in Lowe syndrome.

To evaluate the ophthalmic and anesthesiologic management of cataract surgery in children with Lowe syndrome receiving lens removal, the development and management of secondary glaucoma. This retrospective case series included 12 eyes of 6 children with genetically verified Lowe syndrome receiving cataract removal. Information regarding the type and duration of surgery and total anesthesia time were recorded. Additionally, intra- and postoperative complications were noted as well as clinical examinations such as visual acuity and funduscopy. All children received simultaneous bilateral cataract surgery at the mean age of 8.98±3.58wk. Lensectomy combined with posterior capsulotomy and anterior vitrectomy was performed in all children. The mean time for cataract surgery per eye was 35.83±8.86min, whereas the total time of surgery was 153.33±22.11min. The mean extubation time and duration at recovery room was 42.33±22.60min and 130.00±64.37min, respectively. During surgery, a decrease of oxygen saturation below 93% was found in only one child. During the postoperative follow-up, nystagmus (6 children) and strabismus (5 children) was commonly found in contrast to no case of visual axis opacification. Secondary glaucoma developed in five eyes of three children, which was treated with topical eye drops in only one child. A trabeculectomy was performed in both eyes of one child, whereas removal of syechia and an iridectomy in one eye of one child. Bilateral simultaneous cataract surgery under general anesthesia is a safe surgical procedure in Lowe syndrome children. The glaucoma screening with intraocular pressure measurements is crucial in the postoperative management of Lowe syndrome patients to avoid additional visual impairment.