Background: To evaluate the safety of immediate sequential bilateral cataract extraction (ISBCE)
with respect to indications, visual outcomes, complications, benefits and disadvantages. Methods:
This is a retrospective review of all ISBCEs performed at Kantonsspital Winterthur, Switzerland,
between April 2000 and September 2013. The case notes of 500 eyes of 250 patients were reviewed.
Of these 500 eyes, 472 (94.4%) had a straight forward phacoemulsification with posterior
chamber intraocular lens implantation; 21 (4.2%) had a planned extracapsular cataract extraction;
4 (0.8%) had an intracapsular cataract extraction and 3 (0.6%) had a combined phacoemulsification
with trabeculectomy. Results: Over 66% of eyes achieved improved visual acuity (at least 3
Snellen lines) following ISBCE. Median preoperative best corrected visual acuity (BCVA) was 0.5
LogMAR; the interquartile range was [0.4, 1] LogMAR. At one week control the median BCVA was
0.3 LogMAR, IQR [0.1, 0.5] LogMAR. At one month the median BCVA was 0.15 LogMAR, IQR [0.05,
0.3] (p < 0.01). There were no sight-threatening intraoperative or postoperative complications
observed. Conclusions: ISBCE is an effective and safe option with high degree of patient satisfaction.
The relative benefits of ISBCE should be balanced against the theoretically enhanced risks.