title: Immediately sequential versus delayed sequential bilateral cataract surgery: safety and effectiveness.
abstract: OBJECTIVE
  To assess the safety and effectiveness of immediately sequential (ISBCS) versus delayed sequential (DSBCS) bilateral cataract surgery.
  
  
  METHODS
  Multiple clinics, Canary Islands, Spain.
  
  
  METHODS
  Multicenter randomized clinical trial.
  
  
  METHODS
  Patients with cataracts requiring bilateral surgery were randomized to ISBCS or DSBCS. Outcome measures were the incidence of intraoperative and postoperative surgical complications, corrected and uncorrected visual acuities, and self-perceived visual function (VF-14 questionnaire). All outcomes were measured 30 days postoperatively. Self-perceived visual function was also assessed after 1 year. Data were analyzed with repeated measures to assess temporal effects on surgical complications, visual acuity, and function. Effect size was also estimated for self-perceived visual function.
  
  
  RESULTS
  There were no differences in intraoperative or postoperative surgical complications, visual acuity 30 days postoperatively, or self-perceived visual function after 1 year between the 2 techniques. Effect size for visual function 30 days postoperatively was moderate in the ISBCS group (n = 834) and small in the DSBCS group (n = 780). This difference disappeared at 1-year follow-up after second-eye surgery in the delayed group.
  
  
  CONCLUSIONS
  There were no relevant surgical complications in 1614 operated eyes and no significant difference in surgical complications, visual acuity, or long-term self-perceived visual function between ISBCS and DSBCS. These safety and effectiveness outcomes were related to careful patient selection, surgical expertise, and the systematic use of standardized surgical guidelines to ensure aseptic and independent surgery in each eye.
authors.affiliation: Evaluation and Planning Unit, Canary Islands Health Service, Canary Islands, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Serrano-Aguilar
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Ramallo-Fariña
authors.forename: José María
authors.initials: JM
authors.lastname: Cabrera-Hernández
authors.forename: David
authors.initials: D
authors.lastname: Perez-Silguero
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Perez-Silguero
authors.forename: Francisco
authors.initials: F
authors.lastname: Henríquez-de la Fe
authors.forename: Javier
authors.initials: J
authors.lastname: Goás-Iglesias de Ussel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D019591:Pseudophakia / Q000503:physiopathology; D018434:Sickness Impact Profile; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*