Search

Purpose: To evaluate the refractive outcomes, complication rates, and changes in patients' functional state and satisfaction with simultaneous compared with sequential bilateral cataract surgery., Setting: Helsinki University Eye Hospital, Helsinki, Finland., Design: Clinical trial., Methods: Consecutive patients scheduled for bilateral cataract surgery were enrolled based on appropriate inclusion criteria and randomized to be operated on in 1 session (study group) or sequentially (control group) 4 to 6 weeks apart., Results: Four hundred ninety-one (94.4%) of the 520 patients completed the study. Of the eyes, 493 (247 patients) had bilateral surgery in 1 session and 506 (257 patients) in separate sessions. In the study group, 240 patients (96.0%) were treated per protocol. In the control group, 250 patients (97.3%) were treated per protocol. The refraction was within ± 0.50 diopter (D) of the target in 67.2% of eyes in the study group and 69.2% of eyes in the control group and within ± 1.00 D in 91.0% and 90.3%, respectively (P = .92). The only complication that affected postoperative visual acuity was chronic cystoid macular edema, which occurred in 1 eye in the study group (0.2%) and in 2 eyes (0.4%) of 1 patient in the control group (P = .57). Ninety-five percent of patients in both groups reported being very satisfied with surgery., Conclusion: The refractive outcomes, rates of complications, and patient-rated satisfaction were similar whether bilateral cataract surgery was performed simultaneously or sequentially., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery., Setting: Helsinki University Eye Hospital, Helsinki, Finland., Design: Economic analysis., Methods: Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery., Results: The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros (€) per patient in health-care costs and €739 when travel and paid home-care costs were included. The savings added up to €849 per patient when the cost of lost working time was included., Conclusion: Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care-related costs., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)