Sustained practice of immediate sequential bilateral cataract surgery (ISBCS) in a post-COVID era

Abstract

Dear Editor,We are writing to share our experience on the sustained practice of Immediate Sequential Bilateral Cataract Surgery (ISBCS) at our hospital, in light of Wang et al.'s 1 recent publication. Similarly in this cycle we have found that ISBCS is a safe practice that is favoured by both patients and surgeons with appropriate case selection, proving that it is not only the end product of Covid-19. In fact, we have observed a slightly higher percentage of ISBCS procedures performed at our institution in this cycle (July 2021 to June 2022; 7.6% [280/3687]) compared to the previous year (July 2020 to July 2021; 6.1% [208/3402]).Retrospective data collection between 1 st July 2021 to 30 th June 2022 were carried out in Sheffield Teaching Hospital through Medisoft (Medisoft Ltd, Leeds, UK). Operations were conducted following the methods described by Wang et al., 1 with the same group of surgeons. Patients demographics, outcomes, and operative data were evaluated in accordance with the tenets of the Declaration of Helsinki.A total of 280 eyes from 140 patients underwent ISBCS. The mean age of the patients was 73.9 ± 9.7 years, with 66% being female. Local anaesthesia was used in 86% of cases, and 81% of surgeries were considered 'routine'. ISBCS was still offered to higher-risk patients, with ocular risk factors shown in Table 1. Intraoperatively, we observed 2 complications in 2 eyes (0.7%), which is a lower incidence compared to the previous cycle of the study (1.4%). Furthermore, our findings showed a reduction in post-operative complications (9.6% in 2020). Of the 280 eyes, 16 (5.7%) reported post-operative complications and were resolved through appropriate management. Notably, despite the unchanged post-operative treatment regimen, we also observed a lower rate of cystoid macular oedema. There were no instances of endophthalmitis or toxic anterior segment syndrome in this cohort.The mean pre-operative PHVA was 0.459 ± 0.513 LogMAR (n = 280), which improved to 0.170 ± 0.288