Simultaneous, sequential bilateral cataract surgery yield similar postop outcomes

J Cataract Refract Surg. 2011;37(6):992-1002.

Simultaneous and sequential bilateral cataract surgery offered comparable refractive outcomes, complication rates and patient satisfaction, the Helsinki Simultaneous Bilateral Cataract Surgery Study found.

"Patients with bilateral cataract often benefit from second-eye surgery," the study authors said. "They have better self-assessed visual outcomes and satisfaction with vision than patients after first-eye surgery. In addition, second-eye cataract surgery is cost-effective compared with other interventions."

The randomized clinical trial included 493 eyes of 247 patients who underwent bilateral surgery in one session. A control group comprised 506 eyes of 255 patients who had surgery in separate sessions 4 to 6 weeks apart.

Mean patient age was 75.3 years in the study group and 75 years in the control group.

All patients underwent phacoemulsification with implantation of an AcrySof MA30 or MA60 acrylic IOL (Alcon) through a 3.5-mm clear corneal incision.

Snellen corrected distance visual acuity, manifest refraction, biometry and keratometry were assessed preoperatively and 1 day and 1 month postoperatively. Ocular and systemic comorbidities and complications were also evaluated.

The Visual Function Index-7 was used to assess visual function preoperatively and 3 to 5 weeks postoperatively. The Cataract Symptom-5 score was used to assess the severity of cataract symptoms.

At 1 month, postoperative refraction was within 0.5 D of the target value in 67.2% of eyes in the study group and 69.2% of eyes in the control group, the results showed.

Also at 1 month, corrected distance visual acuity in the better eye was 20/25 or better in 77.1% of eyes in the study group and 68% of eyes in the control group.

Both groups also had similar Visual Function Index-7 scores; 95% of patients in both groups were very satisfied, the authors reported.