The authors present a retrospective cohort study with the aim of comparing the outcomes and complications of immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS). Children (aged 0–24 months) undergoing bilateral cataract surgery at a single centre within a 10-year period and remaining aphakic for at least 12 months were included. Cases with intraocular lens implantation, previous eye surgery or incomplete data were excluded. The options of ISBCS and DSBCS were presented at the time of listing, with a joint decision made between parents and the surgeon. The following data was extracted from the medical records: demographics, medical history, total anaesthesia time, intraoperative complications, ocular complications, postoperative outcome and number of follow-up visits. A total of 56 cases were identified, 23 underwent ISBCS and 33 DSBCS. No significant differences in the demographics of the 2 groups were identified, however, the ISBCS had a significantly higher case rate of congenital heart defects. The mean time under anaesthesia was significantly shorter for the ISBCS group (100.0 minutes) compared with the DSBCS group (141.1 minutes). No significant differences in the intraoperative and postoperative complications were found between the 2 groups. The number of follow-up visits did not differ significantly, however, the DSBCS group spent significantly more nights as inpatients (2.9 vs 1.3). The authors note several limitations of the study including the retrospective methodology and small sample size. The advantages of ISBCS in relation to anaesthesia should be considered in discussions with parents when deciding between ISBCS and DSBCS.
How do immediate and sequential bilateral cataract surgery compare?
Reviewed by Lauren Hepworth
Bilateral cataract surgery in children: immediate sequential versus delayed sequential surgery.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
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