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Outcomes of immediate sequential bilateral cataract surgeries (ISBCS) performed by trainees vs consultants: a two-armed cohort study

Eye volume 39, pages 1724–1729 (2025)Cite this article

Subjects

Abstract

Purpose

To compare outcomes of Immediate Sequential Bilateral Cataract Surgeries (ISBCS) performed by resident doctors versus consultant ophthalmologists at Moorfields Eye Hospital and its satellite centres.

Methods

The study reviewed ISBCS performed by phacoemulsification and intraocular lens implant, comparing resident ophthalmologists (Gr1) and consultant ophthalmologists (Gr2). Outcomes examined included complications, refraction (spherical equivalent (SE) > 0.5D and >1.0D from predicted target refraction), and uncorrected distance visual acuity (UDVA logMAR) at three months post-ISBCS.

Results

The study included 553 eyes in Gr1 and 687 in Gr2. UDVA post-surgery was similar in both groups (P = 0.26). Intra- and postoperative complications were comparable between groups [RR = 1.88 (95% CI 0.8; 4.2) P = 0.13]. We found no statistically significant difference in refractive outcomes between groups (Gr1 [–0.12 D (IQR –0.5; –0.25)] and Gr2 [–0.25D (IQR –0.63; –0.13)] (P = 0.08)). Similarly, no difference was found in patients with >1.0D SE predicted refractive outcome between groups (6% of Gr1 and 3.9% of Gr2 (P = 0.142)). The grade of the surgeon, PCR risk, and predicted refraction were not significant predictors of postoperative refractive error (SE > 0.5D).

Conclusions

ISBCS outcomes by resident ophthalmologists were comparable to those by consultants. Given the broader fiscal and workforce challenges, our findings advocate that resident ophthalmologists performing ISBCS under supervision may enhance training opportunities.

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Fig. 1: Uncorrected Distance Visual acuity (UDVA) before and 8 weeks after in eyes immediate sequential bilateral cataract surgeries (ISBCS).

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Data availability

The datasets generated and analysed during the current study are available from the corresponding author upon reasonable request. Any restrictions on data availability (e.g., due to patient confidentiality or third-party agreements) will be addressed individually with requesters to ensure compliance with ethical and legal requirements.

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Author information

Authors and Affiliations

  1. Moorfields Eye Hospital, London, UK

    Rajesh Deshmukh, Mumta Kanda, Lucy Barker & Alex Ionides

  2. Department of Adnexal Surgery, Moorfields Eye Hospital, London, UK

    Mohsan Malik

  3. Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK

    Sam Myers

  4. UCL Institute of Cardiovascular Science and NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK

    Alasdair Warwick

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  1. Rajesh Deshmukh
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Contributions

RD conceived the idea, wrote the initial draft, and conducted the data analysis. MM contributed to the manuscript through data collection, analysis, and editing. SM assisted with data collection and the review of the article. AW and MK analysed and evaluated the data. LB and AI edited and assessed the data. All authors critically reviewed and approved the final manuscript.

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Correspondence to Rajesh Deshmukh.

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The authors declare no competing interests.

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Presentation Information: This work was presented as an oral poster at the European Society of Cataract and Refractive Surgeons (ESCRS) Congress 2024 in Barcelona, Spain.

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Deshmukh, R., Malik, M., Myers, S. et al. Outcomes of immediate sequential bilateral cataract surgeries (ISBCS) performed by trainees vs consultants: a two-armed cohort study. Eye 39, 1724–1729 (2025). https://doi.org/10.1038/s41433-025-03739-9

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