Surgery on both eyes on same day or on different days: which | Figure 1
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Surgery on both eyes on same day or on different days: which is best to treat cataract in both eyes?
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Key messages
‐ Current evidence supports there may be no important difference between surgery on both eyes on the same day (ISBCS) and surgery on different days (DSBCS) for the following clinical outcomes: eye (ocular) infection (endophthalmitis, a severe, sight‐threatening but rare complication), spectacle correction after surgery (refraction), complications, vision with spectacle correction (if needed), and patient‐reported outcomes (PROMs; questionnaires on vision).
‐ Current evidence supports the costs for ISBCS are lower compared to DSBCS, but evidence on the balance between the costs and how well it works (cost‐effectiveness) was lacking.
‐ Overall, the amount and quality of the evidence was limited.
We found 14 studies that involved 276,260 people (7384 who had ISBCS and 268,876 who had DSBCS).
Main results
‐ Endophthalmitis: the type of surgery (ISBCS or DSBCS) may make little to no difference in the occurrence of endophthalmitis in one eye (up to six weeks after surgery). No studies reported endophthalmitis in both eyes, but it is most likely too rare to be detected by these studies.
‐ Refractive outcomes: there is probably little to no difference in refractive outcomes at one to three months after surgery with ISBCS compared to DSBCS.
‐ Other complications: there may be little to no difference in other complications up to three months after surgery with ISBCS compared to DSBCS, but we are very uncertain about the results.
‐ Costs: the economic studies in this review reported lower costs for ISBCS compared to DSBCS. One study reported that ISBCS is cost‐effective compared to DSBCS, but we are very uncertain.
‐ Best‐corrected distance visual acuity (BCDVA; vision with spectacle correction if needed): the type of surgery (ISBCS or DSBCS) may have little to no effect on BCDVA at one to three months after surgery, but we are very uncertain about the results.
‐ PROMs (measured in questionnaires): the type of surgery (ISBCS or DSBCS) probably makes little to no difference in PROMs at one to three months after surgery.
What are the limitations of the evidence?
Overall, we had moderate to very little confidence in the evidence (endophthalmitis: little confidence, refractive outcomes: little to moderate confidence, complications: not confident, costs: little to no confidence, BCDVA: not confident, and PROMs: moderate confidence).
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