Sequential Bilateral Cataract Surgery Research Articles

Ten-year trends of delayed sequential bilateral cataract surgery (DSBCS) in Sweden: a register-based study.

To study the trend of delayed sequential bilateral cataract surgery (DSBCS) in Sweden in the past decade. This register-based cohort study utilized data from the Swedish National Cataract Register (NCR) from 2010 through 2019. Register files from patients who underwent cataract surgery in both eyes during the study period were linked using their social security numbers. Bilateral surgeries on different days were classified as DSBCS. The study investigated the association between DSBCS within 3months and several variables with stratification and multivariate logistic regression. The following variables were used: operation year, region, private or public unit, age, sex, indication for surgery, type of intraocular lens (IOL), preoperative visual acuity, ocular comorbidity, posterior capsule rupture and perioperative difficulties. During the study period, 368,106 patients underwent DSBCS, of which 62.6% (n = 230,331) had bilateral surgery within 3months. The median time between the surgeries was 61days (interquartile range 26-161days), showing regional variations. Better visual acuity in the fellow eye, presence of ocular comorbidity, various perioperative events and complications were associated with longer time to surgery of the second eye. Conversely, cataract surgery in more recent years, private clinic, increasing age, anisometropia and multifocal IOL were associated with shorter timespan between surgeries. The majority of DSBCS were conducted within a 3-month timeframe, with the interval between surgeries decreasing throughout the study period. Several rational factors were associated with the time difference, in addition to regional variations. Many patients would probably benefit from less time between the surgeries, and we encourage a clinical practice taking the whole patient's visual function into account.

Bilateral cataract surgery in children: immediate sequential versus delayed sequential surgery

PurposeTo compare ocular and anesthesia-related complications in a cohort of patients having undergone either delayed sequential bilateral cataract surgery (DSBCS) or immediate sequential bilateral cataract surgery (ISBCS). MethodsThe medical records of children who underwent bilateral cataract surgery at our institution between 2012 and 2021were reviewed retrospectively. Included patients were 0-24 months of age, aphakic, and followed for at least 1 year after surgery. ResultsA total of 56 children were included: 23 underwent ISBCS; 33, DSBCS. Mean age at surgery was 2.6 ± 2.5 months for ISBCS patients and 2.8 ± 3.0 months for DSBCS patients (P = 0.752). Association with systemic diseases was more common in the ISBCS group. The mean anesthesia time per child was shorter in the ISBCS group (P < 0.001), although the mean total procedure time was similar in both groups. The rate of intraoperative anesthesia-related complications and intraocular complications was similar in both groups. There were no cases of endophthalmitis. The mean number of additional surgical interventions per child and the mean number of follow-up visits within 1 year were similar between groups. Children in the ISBCS group required fewer nights of hospital admission (P < 0.001). ConclusionsISBCS in children in this series did not lead to an increased incidence of ocular or anesthesia-related complications compared with DSBCS. ISBCS avoids repeated anesthesia and shortens the total time that the child is under anesthesia.

Scleral imbrication with vitreoretinal surgery as a primary procedure for retinal detachment in pathological myopia.

A 45-year-old male presented with diminution of vision in the right eye (RE) for the past 2 weeks. He underwent sequential bilateral cataract surgery 25 years ago, with an intraocular lens in RE, which was his better eye. The left eye was aphakic with a thick fibrous membrane at the pupillary plane. Visual acuity was hand movement in the RE with the iris claw lens and total bullous retinal detachment (RD). The axial length with RD was 28.6 mm in RE and 29 mm in the left eye (LE). We did a vitrectomy with scleral imbrication, endolaser, fluid gas exchange, and tamponade in the RE. The LE developed RD subsequently, and he underwent similar surgical procedures in his LE. The best corrected visual acuity in his RE was 20/80, and that in the LE was 20/120 on follow-up. RD with staphyloma is a surgical challenge as the thin atrophic retina at the posterior pole fails to conform to the concavity of staphyloma. Vitrectomy with tamponade alone does not take care of staphyloma and has more chances of recurrent detachment or persistent fluid at the posterior pole. Scleral imbrication shallows the staphyloma cavity and shortens the axial length, thereby giving a good surgical outcome.

Immediate sequential bilateral cataract surgery: Prevalence, attitudes and concerns Among Italian ophthalmologists.

to investigate the existing practice patterns of immediate sequential bilateral cataract surgery (ISBCS) in Italy and to assess ophthalmologists' attitudes towards performing ISBCS in the future for cataract treatment. It is a multicenter cross-sectional study. From February,1st 2023 to March, 1st 2023 the Members of the Italian Society of Cataract and Refractive Surgery (AICCER) as well as the attendees of its annual national congress were invited to anonymously complete an electronic 7-item questionnaire on their current ICBCS practice. Questions included the average number of procedures per month, the main indications for ICBCS, and the main reasons for performing and not performing ISBCS. Data were analyzed using descriptive statistics. of the 2300 recipients, 246 (10.7%) completed the survey. Of the respondents, 156 (63.4%) replied to perform ISBCS, most of them (82%) occasionally (1 to 5 procedures per month). Fifty-three percent (130 ophthalmologists) considered adopting ISBCS as routine practice in the near future. The conditions most considered for ISBCS were age-related cataract surgery under general and topical anesthesia and congenital cataract surgery. The availability of separate instruments for the two eyes as well as patient and hospital advantages were the most important reasons for performing ISBCS. The risk of bilateral endophthalmitis and medicolegal issues were the main reasons for not performing ISBCS. ISBCS remains controversial among Italian surgeons, despite growing evidence of its safety and efficacy. The risk of potentially blinding complications such as bilateral endophthalmitis, together with medicolegal concerns are the principal barriers to ISBCS implementation in routine practice.

A survey exploring ophthalmologists' attitudes and beliefs in performing immediate sequential bilateral cataract surgery in Singapore.

To evaluate current practice patterns of Immediate Sequential Bilateral Cataract Surgery (ISBCS) by ophthalmologists in Singapore and assess their attitudes towards performing ISBCS in future cataract care. An anonymised electronic survey, modified to local context from a similar study conducted in the United Kingdom, was distributed to members of the College of Ophthalmologists, Academy of Medicine, Singapore, from 20 June to 1 September 2023. An initial screening question on prior experience with ISBCS directed the rest of the survey. Questions explored ophthalmologists' current ISBCS practice patterns and the importance of factors affecting their willingness to perform ISBCS. Results were descriptively analysed. Results collated 2 months upon survey dissemination saw a total of 58 respondents from 235 eligible members (24.7% response rate). Of these, 16 (27.6%) were currently performing ISBCS, 37 (63.8%) had never performed, and 5 (8.6%) had stopped performing. In considering ISBCS, patient convenience (n = 11, 68.8%) and reduced hospital visits (n = 8, 50.0%) were the most important factors nominated. The most important barriers to performing ISBCS were medico-legal issues (n = 31, 83.8%) and risk of endophthalmitis (n = 27, 73.0%), followed by perceived lack of evidence for its effectiveness (n = 19, 51.4%). This is one of the first studies evaluating ophthalmologists' sentiments towards performing ISBCS in an Asian country. It highlights some of the most pertinent barriers and concerns that ophthalmologists face in performing and offering ISBCS. This study provides a better understanding of the potential role and prospects of ISBCS in future cataract care in Singapore.

Implementing immediate sequential bilateral cataract surgery at Buckinghamshire Healthcare NHS Trust.

Immediate sequential bilateral cataract surgery (ISBCS) was first introduced into NICE guidelines in 2017. In this approach, patients undergo cataract surgery on both eyes on the same day. Although increasingly popular, only 0.5% of all cataract operations nationally are performed using this approach. We redesigned our service to routinely offer ISBCS and are now one of the leading NHS providers of ISBCS in the UK. We audited our cataract operations in 2022 and report our initial experiences with ISBCS here. We redesigned our cataract service to routinely offer ISBCS on the NHS. We audited all cataract operations performed in calendar year 2022. We performed 4652 NHS cataract operations including 498 (10.7%) operations on 249 patients using the ISBCS approach. Trainee surgeons performed 32.5% of these cases. There were two intraoperative complications, both during the second eye operation. One was a suspected suprachoroidal haemorrhage and the other was a posterior capsular rupture post lens implantation. Post-operatively there was one case of retinal detachment requiring vitrectomy following uncomplicated ISBCS and five cases of Irvine-Gass syndrome that were managed medically. From this data, ISBCS does not pose a greater risk to patients in terms of complications. Allowing trainees to operate on ISBCS cases improves the trainee experience. With appropriate pre-operative counselling, patients listed for unilateral surgery can be converted to ISBCS on the day of operation to fully utilise theatre capacity. Patients listed for ISBCS can also be converted to unilateral surgery on the day of operation when surgeons need time to deal with complications safely.

Bilateral spontaneous Descemet membrane detachment after uneventful immediate sequential bilateral cataract surgery

Introduction: Immediate sequential bilateral cataract surgery (ISBCS) is a practice on the rise. To the authors' knowledge, this is the first reported case of bilateral Descemet membrane detachment (DMD) after uneventful same-day ISBCS, with emphasis on diagnosis and management. Patient and Clinical Findings: The case of a 66-year-old diabetic woman with chronic obstructive pulmonary disease and obstructive sleep apnea on home oxygen who developed spontaneous bilateral DMD after uneventful ISBCS for visually significant cataracts is presented. Although spontaneous DMD after uneventful phacoemulsification has been reported before, it has not been reported after same-day ISBCS to the authors' knowledge. The success rates with air pneumatic descemetopexy are excellent, with ranges between 90% and 95%. In this case, surgical intervention with gas injection in the anterior chamber and surgical peripheral iridotomies resulted in excellent visual acuity restoration in the patient. Diagnosis, Intervention, and Outcomes: Patient underwent same-day ISBCS under local anesthesia by different surgeons in either eye. Standard phacoemulsification techniques were used, and no intraoperative complications were noted. The patient returned with bilateral counting fingers vision 4 weeks postoperatively and reported her vision never improved after her cataract extraction. Anterior segment optical coherence tomography (AS-OCT) confirmed the presence of bilateral DMDs. Because of the patient's severely impaired vision, bilateral air descemetopexies were performed with clinical resolution of the DMD and excellent restoration of vision in both eyes. Conclusions: Sufficient evidence supports that performing ISBCS using internationally agreed protocols minimizes the risk of experiencing bilateral complications to a negligible level when compared with staged surgery. However, with ISBCS being on the rise, spontaneous bilateral DMDs may also be seen increasingly in those eyes with no underlying commonly recognized risk factors for spontaneous DMD. With unilateral DMD, watch and wait is a viable option. However, in bilateral DMD cases, earlier air or gas descemetopexy may be preferable to increase the likelihood of success and reduce the patient's period of decreased vision.

Where We Are Now: A Survey Exploring Colombian Ophthalmic Surgeons\' Attitudes on Performing Immediate Sequential Bilateral Cataract Surgery

Where We Are Now: A Survey Exploring Colombian Ophthalmic Surgeons\' Attitudes on Performing Immediate Sequential Bilateral Cataract Surgery

Trends in immediate sequential bilateral cataract surgery in Ontario

ObjectiveBecause of increased evidence for safety and increased demands, there appears to be a recent adoption and endorsement of immediate sequential bilateral cataract surgery (ISBCS). This study aims to determine whether a paradigm shift has occurred in the delivery of cataract surgery in the province of Ontario and its the extent, if any, and to analyze the current role of ISBCS. DesignRetrospective health records analysis. MethodsWe analyzed aggregate Ontario Health Insurance Plan claim counts for cataract surgeries between 2016 and 2022, categorizing cases into unilateral, ISBCS, and delayed sequential bilateral cataract surgery (DSBCS) cases. We examined trends, compared wait times for second surgeries in the DSBCS cohort with wait times for first surgeries, and used previously published cost estimates for ISBCS to estimate annual savings in Ontario. ResultsThere were 1,122 ISBCS cases in 2016, which increased sixfold during the pandemic (2020–2021) and further increased to 11,876 cases in 2022. Unilateral and DSBCS cases decreased during the pandemic but rebounded in 2022 to 102% and 153% of baseline, respectively. ISBCS increased from 1% to 10%, unilateral cases decreased from 41% to 29% of total cases, and DSBCS increased from 58% to 61%. Median wait for patients’ first and second surgeries increased from 65 to 87 days and 28 to 33 days, respectively. Using estimates, ISBCS saved approximately $19 million in 2022. ConclusionOur study demonstrates a paradigm shift in Ontario in favour of ISBCS. ISBCS also may be a strategy to reduce increasing wait times while saving health care system dollars.

Raised intraocular pressure after immediate sequential bilateral cataract surgery with EyeCee one intraocular lens

PurposeThe Medicine and Healthcare products Regulatory Agency (MHRA) reported cases of high intraocular pressure (IOP) after implantation of affected batch numbers of EyeCee One intraocular lens (EC1IOL). In our institution we offered Immediate Sequential Bilateral Cataract Surgery (ISBCS) with EC1IOL and here we examine the rate of raised IOP, management of cases and outcomes of this group. DesignRetrospective case series review. MethodsA search of our electronic patient record system identified 27 patients who had ISBCS with EC1IOL. Patients with IOP ≥30 mmHg at a post op visit were identified as the “spike” group and a case series review performed. Results43 eyes (27 patients) had an affected batch number of EC1IOL implanted during ISBCS, 16 patients had an affected lens in both eyes and 11 in one eye. 7% (3 eyes of 3 patients) had a post op IOP spike (average 51.9 mmHg) at a post-op visit felt to be EC1IOL related. Patients required immediate treatment, an average of 3.33 regular topical IOP lowering agents and 5 outpatient appointments. Using the fellow eye as a control comparison, 2 out of the 3 eyes in the spike group had less visual improvement. 1 eye in the spike group lost 0.2 LogMAR lines. ConclusionsWe found a greater rate EC1IOL related IOP spikes than the MRHA reports. There was a trend towards less visual gain post operatively in patients who had a spike, but due to small numbers meaningful statistical analysis cannot be performed. Surgical intervention was not required in this cohort.

Immediate Sequential Bilateral Cataract Surgery in Patients with Bilateral Visually Significant Cataracts.

To report our experience of performing immediate sequential bilateral cataract surgery (ISBCS) in patients with visually significant cataracts and reduced preoperative corrected distance visual acuity (CDVA). Data of patients who underwent ISBCS for visually significant cataracts and had preoperative CDVA ≤20/32 (≤0.2 logMAR) in each eye were retrospectively reviewed. Refractive and visual outcomes were evaluated for the last available postoperative visit. Intraoperative and serious postoperative adverse events occurring within the first three months of surgery were reviewed. A total of 1335 patients (2670 eyes) were included in the analysis, with a mean age of 71.9 ± 9.5 years. On the last visit, 50.2% and 89.1% of eyes achieved uncorrected distance visual acuity (UDVA) ≥20/20 (0.0 logMAR) and ≥20/32 (0.2 logMAR), respectively. Of all eyes, 83.8% were within ±0.50D, and 96.4% were within ±1.00 D of emmetropia. Ten patients had postoperative bilateral ametropia of more than 1.00D in each eye, but eight of them still achieved binocular UDVA ≥20/40. Intraoperative events occurred in 14 eyes of 13 patients (per-eye incidence: 0.524% or 1 in 191 eyes). A total of 86 postoperative adverse events occurred in 80 eyes of 53 patients (per-eye incidence 2.996% or 1 in 33 eyes), of which cystoid macular edema was the most common. Only three eyes had CDVA reduced by more than two Snellen lines compared to preoperative CDVA, two of which were not related to cataract surgery. There was no patient with bilateral CDVA loss. In our cohort of patients with visually significant cataracts, ISBCS resulted in good refractive predictability and a low incidence of serious adverse events.

Refractive outcomes of immediately sequential bilateral cataract surgery in eyes with long and short axial lengths

PurposeTo report the refractive outcomes of long (≥25.00 mm) and short (≤22.00 mm) axial length (AL) eyes undergoing immediately sequential bilateral cataract surgery (ISBCS).MethodsIn this retrospective cohort study, patients who underwent ISBCS were identified and eyes of patients with bilateral long and short ALs were included. Pre- and postoperative biometry, autorefraction, and ocular comorbidities or complications were recorded. The primary outcome was the mean refractive prediction error.ResultsThirty-seven patients (74 eyes) with long ALs and 18 patients (36 eyes) with short ALs were included. The means ± standard deviations of the ALs were 26.40 ± 1.38 mm and 21.44 ± 0.46 mm in the long and short AL groups, respectively. In long AL eyes, the mean absolute error from the biometry-predicted refraction was − 0.16 ± 0.46 D, corresponding to 74% of eyes achieving a refraction within ±0.50 D of the predicted value. In short AL eyes, the mean absolute error was − 0.63 ± 0.73 D, corresponding to 44% of eyes achieving a refraction within ±0.50 D of the predicted value. Eight (44.4%) patients with short AL eyes had a myopic deviation greater than ±0.50 D from the predicted result in both eyes.ConclusionsCompared to patients with long AL eyes, ISBCS in patients with short ALs had a wider variance in refractive outcome and a lower rate of achieving a postoperative refraction within ±0.50 D of the predicted target.

Immediate Bilateral Sequential Cataract Surgery (IBSCS): Special Procedure for Specific Patients

Abstract&#x0D; Introduction &amp; Objectives : Immediate Bilateral Sequential Cataract Surgery (IBSCS) are still controversial topic in Ophthalmology. This paper aims to report the outcome and the efficacy of Immediate Bilateral Sequential Cataract Surgery in writer’s experience.&#x0D; Methods : This paper collects datas from 150 patients that underwent IBSCS. The procedure was done if patient have one or more from these criteria: live far away from hospital, difficult to mobilize to hospital, extreme urgency to return to work as fast as possible (daily paid worker), and if general anesthesia was used. The exclusion criterias were if there was intraoperative complication during the 1st eye, any posterior segment abnormality, and in complicated cataract cases (bad cornea, glaucoma eyes, small pupil eye, zonular loss / weakness, post uveitic eye). During intraoperative, after the 1st eye was finished all instruments and consumable was changed before proceed to the second eye.&#x0D; Results : From 150 patients, there were 0 (zero) case of endophthalmitis. At 7th days post op results all patients achieve normal range pressures, quiet anterior chamber, and good visual acuity improvement.&#x0D; Conclusion : Immediate Bilateral Sequential Cataract Surgery is not less safe than traditional delayed sequential cataract surgery. IBSCS definitely should be considered when encountered with specific patients and specific needs.

Impact of Delayed Sequential Bilateral Cataract Surgery on Diabetic Macular Edema: A Real-World Study in Northwestern China.

To assess the incidence and characteristics of treatment-requiring diabetic macular edema (TR-DME) in eyes after delayed sequential bilateral cataract surgery in patients with diabetes mellitus. This was a retrospective study involving patients with diabetes who underwent cataract surgery at Shaanxi Eye Hospital between January 2019 and December 2021. The incidence and characteristics of a first episode of TR-DME after delayed sequential bilateral cataract surgery were observed. A total of 1553 individuals (3106 eyes) were included in the study. All patients underwent bilateral cataract surgery with the prescribed interval of surgery within one month. The incidence of TR-DME was 0.52% in the year before surgery versus 1.87% in the year after surgery (p < 0.05). The highest risk period was between 2 and 4 months after surgery. A first episode of TR-DME was observed in 58 eyes of 35 patients after delayed sequential bilateral cataract surgery. The patients were divided into four groups according to the interval between bilateral cataract surgeries. A higher incidence of TR-DME was observed when the interval between the surgeries was less than two weeks. This is the first real-world study of the effects of cataract surgery on the development of TR-DME. The study was performed at the largest ophthalmic center in Northwestern China. The findings demonstrate that the incidence of TR-DME increased significantly after cataract surgery, with the highest incidence between two and four months after surgery. Patients with shorter intervals between bilateral cataract surgeries were at a high risk.

Cytokines in aqueous humor of patients with congenital cataract during delayed sequential bilateral cataract surgery

BackgroundTo explore the changes of cytokines expression in aqueous humor (AH) of eyes of patients with congenital cataract (CC) who underwent delayed sequential bilateral cataract surgery (DSBCS).Methods28 patients with CC underwent DSBCS. AH samples were collected from each eye before surgery. The contents of cytokines in AH were detected by Luminex xMAP Technology.ResultsThere was no significant difference in the expression of IL-8, IP-10, MCP-1 and PDGFAA in the AH of the first and second eyes (P = 0.35, 0.39, 0.17, respectively). The level of IL-8 in the first-eye AH was negatively correlated with age (ρ=– 0.519, P = 0.008). IP-10 and MCP-1 in the second-eye AH were negatively correlated with age (ρ=– 0.483, P = 0.009; ρ=– 0.445, P = 0.018,respectively).ConclusionThe first-eye surgery in patients with CC may not cause the change of cytokines in the contralateral eye. The expression of IL-8, IP-10 and MCP-1 in the AH was negatively correlated with the age of patients.Trial registrationThe study was registered at www.chictr.org.cn on March 22, 2022 and the clinical trial number is ChiCTR2200057927.

Patient’s Perception Regarding Vision Related Quality of Life in Immediate Sequential and Delayed Sequential Bilateral Cataract Surgery

Cataract is the main cause of visual impairment and treatable blindness in the world and surgery can restore normal sight to the patients. In bilateral cataract patient, surgery in the second eye is as important and meaningful as surgery in the first eye and it can be performed by immediate sequential (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS). There is no statistically significant difference in surgical complications, visual acuity or long term self-perceived visual function between these two methods. To adopt surgical procedure, to improve the patient’s satisfaction and to improve the quality of services, patient opinion should be a great concern. This evaluative study was done to find out various recommendations and suggestions from patients regarding merits &amp; demerits of both types of cataract surgery that will be helpful for the decision-maker and administrator for future practice of cataract surgery in Canada. In this study, vision related quality of life improved in both groups. Participants in DSBCS group experienced different types of difficulties during the gap period between first eye and second eye cataract surgery i.e. visual imbalance between the two eyes and difficulty in driving. They recommended and suggested that cataract surgery wait time should be reduced and the difficulties experienced during the gap period can be eliminated by adopting ISBCS procedure. Bangabandhu Sheikh Mujib Med. Coll. J. 2023;2(1): 07-13

Immediate sequential vs. delayed sequential bilateral cataract surgery: a systematic review and meta-analysis.

The main aim of this Systematic Review and Meta-analysis was to evaluate the safety and efficacy profile of immediate sequential bilateral cataract surgery (ISBCS) compared to delayed sequential bilateral cataract surgery (DSBCS). MEDLINE Ovid, EMBASE, and CENTRAL databases were searched. Outcome measures were post-operative visual acuity, post-operative spherical equivalent (refractive outcome), endophthalmitis, corneal edema, pseudophakic macular edema and posterior capsule rupture. Thirteen articles met criteria for final inclusion. A total of 11,068,622 participants (18,802,043 eyes) were included. No statistically significant differences between ISBCS or DSBCS was identified in all the postoperative outcomes evaluated. However, a higher risk for posterior capsule rupture was identified in the ISBCS group from the pooled analysis of NRSs (RR: 1.34, 95% CI: 1.08 - 1.67, p = 0.0081). In our view, the ISBCS approach has an acceptable safety-efficacy profile, comparable to DSBCS. Future investigations are warranted, with a focus on the analysis of risk factors for surgical complications, patient-reported outcome-measures, and cost effectiveness.

Comparison of Efficacy and Safety between Immediate Sequential and Delayed Sequential Bilateral Cataract Surgery

Purpose: We compared the efficacy and safety of immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS).Methods: We analyzed the best corrected visual acuity (BCVA), spherical equivalent (SE), and mean absolute error (MAE) in the ISBSC and DSBSC groups. The study population comprised 72 patients (144 eyes) who underwent ISBCS and 92 patients (184 eyes) who underwent DSBCS at Seoul St. Mary's Hospital between January 2019 and December 2021.Results: At 1 month postoperatively, the ISBCS group demonstrated a BCVA, SE, and MAE of 0.11 ± 0.09, -0.33 ± 0.42 diopters (D), and 0.38 ± 0.32 D, respectively; similarly, the DSBCS group exhibited a BCVA, SE, and MAE of 0.11 ± 0.15, -0.29 ± 0.56 D, and 0.41 ± 0.43 D, respectively. Furthermore, no significant differences were observed between the ISBCS and the DSBCS groups regarding SE and MAE at the 1-month follow-up for the first and second operated eyes. No cases of postoperative endophthalmitis and toxic anterior segment syndrome were reported.Conclusions: ISBCS is an effective and cost-effective approach that yields favorable postoperative outcomes when performed by an experienced surgeon supported by appropriate pre- and postoperative care, particularly in patients who demonstrate good cooperation.

A quality analysis of internet patient information for immediate, sequential, bilateral cataract surgery (ISBCS).

Due to surgical capacity pressures, induced by the COVID-19 pandemic, immediate bilateral simultaneous cataract surgery (ISBCS) has been utilised increasingly throughout the U.K. This surgical method comes with both novel risks and benefits, so the consent process must be modified. Prior randomised trials have demonstrated that appropriate online information may act as an adjunct to the surgical consent process. This study aims to assess the quality of available internet information for ISBCS. Terms searched were 'bilateral cataract surgery patient information', 'double cataract surgery patient information', and 'immediate sequential bilateral cataract surgery patient information'. The Google search engine was used. The DISCERN instrument and JAMA benchmarks were used to assess healthcare information for quality. The Flesch Reading Ease Score (FRE), Flesch Kincaid Grade (FKG) Level and Gunning Fog Score (GFS) were used to assess for readability. HONcode certification was used to assess transparency and quality. Forty-six websites were found. The average DISCERN score was 41.3, meaning a "fair" quality which is below what many patients would anticipate discovering when trying to find information. National Healthcare Service websites had higher DISCERN scores than private healthcare-provided websites (p < 0.01; 95% CI: 1.13-1.88.). Fair patient information for ISBCS has been demonstrated. Specific internet information sources with appropriate information should be further developed, with cited sources, and patients signposted to them if felt appropriate.

Visual outcomes and rotational stability of a new non-diffractive extended-vision toric intraocular lens

ObjectifÉvaluer les résultats visuels et la stabilité rotationnelle des lentilles intraoculaires (LIO) chez des patients qui subissent une chirurgie de la cataracte bilatérale immédiatement séquentielle s'accompagnant de l'implantation d'une LIO torique non diffractive à profondeur de champ étendue. NatureÉtude de cohorte non comparative réalisée dans un seul établissement. ParticipantsUn total de 20 patients (40 yeux) ayant d'importantes cataractes et un astigmatisme cornéen qui ont subi une chirurgie de la cataracte bilatérale immédiatement séquentielle s'accompagnant de l'implantation d'une LIO de marque AcrySof IQ Vivity Extended Vision (Alcon Laboratories Inc., Fort Worth, Texas). MéthodesL'acuité visuelle non corrigée (AVNC) binoculaire et la meilleure acuité visuelle corrigée (MAVC) monoculaire ont été évaluées pour la vision de loin (6 m), à distance intermédiaire (66 cm) et de près (40 cm) 1 semaine et 3 mois après l'intervention. La stabilité rotationnelle de chacune des LIO a été mesurée au jour 1, après 1 semaine et après 3 mois. Un questionnaire validé sur les troubles visuels (QUVID, pour Questionnaire for Visual Disturbances) a servi à mesurer les troubles visuels subjectifs tels que signalés par les patients avant l'intervention et 3 mois après celle-ci. RésultatsL'AVNC binoculaire de loin, à distance intermédiaire et de près (moyenne ± é.-t.) se chiffrait à 0,00 ± 0,16, à 0,09 ± 0,08 et à 0,14 ± 0,11 logMAR 1 semaine après l'intervention, et à 0,01 ± 0,06, à 0,08 ± 0,08 et à 0,14 ± 0,07 logMAR 3 mois après l'intervention, respectivement. La MAVC monoculaire de loin s'est améliorée : elle est passée de 0,22 ± 0,23 logMAR avant l'intervention à 0,02 ± 0,06 logMAR 3 mois après l'intervention. La MAVC monoculaire à 3 mois s’élevait à 0,08 ± 0,08 logMAR pour la vision à distance intermédiaire et à 0,05 ± 0,08 logMAR pour la vision de près. La rotation des LIO par rapport à l'axe d'implantation prévu était de 2,5 ± 1,7 degrés à la semaine 1 et de 1,7 ± 1,7 degré 3 mois après l'intervention. ConclusionsLa LIO AcrySof IQ Vivity Extended Vision a donné de bons résultats en matière d'AVNC et de MAVC pour la vision de loin, à distance intermédiaire et de près. Cette LIO procure en outre une excellente stabilité rotationnelle en vue de la correction de l'astigmatisme.