Immediate sequential bilateral cataract surgery utilization remains low
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The incidence of immediate sequential bilateral cataract surgery remains low despite endophthalmitis and cystoid macular edema rates comparable to standard delayed surgery, according to a study.
Divya Srikumaran, MD, told Healio/OSN that there has been more interest in immediate sequential bilateral cataract surgery (ISBCS) since COVID-related concerns led to the desire for reduced visits to health care facilities.
“ISBCS has been used a lot more outside of the U.S. and in the Kaiser health care system,” Srikumaran said. “We evaluated rates of ISBCS in the U.S. among Medicare beneficiaries. Medicare pays for the largest proportion of cataract surgery in the U.S.”
Srikumaran and colleagues conducted a retrospective cohort study using Medicare fee-for-service carrier claims data to explore the incidence of ISBCS and delayed sequential bilateral cataract surgery (DSBCS), as well as the factors associated with ISBCS and rates of endophthalmitis and cystoid macular edema after either procedure.
The study identified 4,014 patients who underwent ISBCS (0.2%) and more than 1.9 million who underwent DSBCS (99.8%). Black, Asian and Native American patients were more likely to undergo ISBCS than white patients. Additionally, patients in rural areas were more likely to undergo ISBCS than patients in metropolitan areas.
Conversely, patients with glaucoma, macular degeneration or macular hole/epiretinal membrane were less likely to undergo ISBCS.
Patients who underwent either type of surgery had similar rates of endophthalmitis within 42 days, with no difference in the rates of cystoid macular edema.
“We will need to continue to observe whether the rates of ISBCS will go up as the pandemic continues,” Srikumaran said. “Also, we think it is interesting to consider greater adoption of ISBCS to potentially increase access to cataract surgery services for certain groups.”
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