Abstract
Background/Objectives
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.
Subjects/Methods
We redesigned our cataract service to routinely offer ISBCS on the NHS. We audited all cataract operations performed in calendar year 2022.
Results
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.
Conclusions
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.
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Data availability
The authors declare that the data supporting the findings of this audit are available within the paper.
References
RCOphth: National Ophthalmology Database study of cataract surgery: Key Findings summary 2020–2021. https://nodaudit.org.uk/sites/default/files/2022-07/Key%20Summary%20Findings%202022%20National%20Cataract%20Audit.pdf.
Spekreijse L, Simons R, Winkens B, van den Biggelaar F, Dirksen C, Bartels M, et al. Safety, effectiveness, and cost-effectiveness of immediate versus delayed sequential bilateral cataract surgery in the Netherlands (BICAT-NL study): a multicentre, non-inferiority, randomised controlled trial. Lancet. 2023;401:1951–62.
Dickman MM, Spekreijse LS, Winkens B, Schouten JS, Simons RW, Dirksen CD, et al. Immediate sequential bilateral surgery versus delayed sequential bilateral surgery for cataracts. Cochrane Database Syst Rev. 2022;4. https://doi.org/10.1002/14651858.CD013270.pub2.
Spekreijse LS, Nuijts RMMA. An update on immediate sequential bilateral cataract surgery. Curr Opin Ophthalmol. 2022;34:21–6. https://doi.org/10.1097/ICU.0000000000000907.
Malcolm J, Leak C, Day AC, Baker H, Buchan JC. Immediate sequential bilateral cataract surgery: patient perceptions and preferences. Eye. 2023;37:1509–14.
Carolan JA, Amsden LB, Lin A, Shorstein N, Herrinton LJ, Liu L, et al. Patient experience and satisfaction with immediate sequential and delayed sequential bilateral cataract surgery. Am J Ophthalmol. 2022;235:241–8.
Arshinoff SA, Claoué C, Johansson B. iSBCS general principles for excellence in ISBCS 2009. https://itgo.ca/eyefoundationcanada/wp-content/uploads/sites/5/2020/05/2010-09-01-FINAL-ISBCS-SBCS-suggestions-from-ESCRS-Barcelona.pdf.
Arshinoff SA, Odorcic S. Same-day sequential cataract surgery. Curr Opin Ophthalmol. 2009;20:3–12.
Cataracts in adults: management: NICE guideline NG77; 2017.
Narendran N, Jaycock P, Johnston RL, Taylor H, Adams M, Tole DM, et al. The Cataract National Dataset electronic multicentre audit of 55,567 operations: risk stratification for posterior capsule rupture and vitreous loss. Eye. 2009;23:31–7.
Standard operating procedure for immediate sequential bilateral cataract surgery, Moorfields Eye Hospital NHS Foundation Trust (2020). https://www.moorfields.nhs.uk/sites/default/files/SOP%20Immediate%20Sequential%20Bilateral%20Cataract%20Surgery%20%28v1.01%29%20%28WEB%29.pdf.
Khavandi S, Lim E, Higham A, de Pennington N, Bindra M, Maling S, et al. User-acceptability of an automated telephone call for post-operative follow-up after uncomplicated cataract surgery. Eye. 2023;37:2069–76.
Shah V, Naderi K, Maubon L, Jameel A, Patel DS, Gormley J, et al. Acceptability of immediate sequential bilateral cataract surgery (ISBCS) in a public health care setting before and after COVID-19: a prospective patient questionnaire survey. BMJ Open Ophthalmol. 2020;9:5.
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SM and MA conceived and implemented the presented work into the cataract service. CK and EB audited the data and wrote the manuscript. All authors contributed to the final version of the manuscript.
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King, C., Botcherby, E.J., Adams, M. et al. Implementing immediate sequential bilateral cataract surgery at Buckinghamshire Healthcare NHS Trust. Eye 38, 2981–2984 (2024). https://doi.org/10.1038/s41433-024-03202-1
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DOI: https://doi.org/10.1038/s41433-024-03202-1
