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  • Immediate Sequential Bilateral Cataract Surgery: Trends and Outcomes

    By Lynda Seminara
    Selected by Russell N. Van Gelder, MD, PhD
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    Journal Highlights

    Ophthalmology, May 2022

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    Malwankar et al. used Medicare claims data to explore trends and outcomes of immediate sequential bilateral cataract surgery (ISBCS) in the United States. They found that even though ISBCS use remained low through 2019, the rates of endophthalmitis and cystoid macular edema (CME) were compara­ble for ISBCS and delayed sequential bilateral cataract surgery (DSBCS). They recommend that similar reviews be conducted for the COVID-19 era to understand whether the pandemic has influenced acceptance of ISBCS.

    For this study, the authors reviewed and compared data for Medicare patients who had ISBCS or DSBCS from 2011 through 2019. In addition, they used logistic regression to explore factors associated with ISBCS. Main outcomes included incidence of ISBCS and DSBCS; demographic, ocular, and medical factors relating to ISBCS use; and the rates of endophthalmitis and CME for both approaches.

    Altogether, 1,944,979 patients were identified from the claims data. Of these, 4,014 patients (0.2%) under­went ISBCS; all others received DSBCS (1,940,965 [99.8%]). ISBCS was more common in patients of Black, Asian, and Native American races than in those who were White (respective odds ratios [ORs]: 2.31, 1.82, and 2.42). Patients in rural regions were more likely to undergo ISBCS than were residents of metropolitan areas (OR, 1.26). Surgery performed in a hospital, rather than an ambulatory surgery center, trended toward ISBCS (OR, 2.71). Bilateral cases that were deemed “complex” were more likely than non­complex cases to receive ISBCS (OR, 3.23). Patients with a Charlson comor­bidity score of at least 1 were more apt to have ISBCS, whereas patients with glaucoma, macular degeneration, macular hole, or epiretinal membrane were more likely to have DSBCS. The difference in rates of endophthalmitis occurring within six weeks was not sig­nificant, nor was the difference in CME rates.

    The original article can be found here.