Cornea, Cataract and Refractive Surgery Unit, Department of Ophthalmology, Hospital Quironsalud Marbella, Marbella.
Research and Development Department, and Refractive Surgery Department, VISSUM, VISSUM Instituto Oftalmológico de Alicante, Grupo Miranza.
Curr Opin Ophthalmol. 2024 Jan 1;35(1):17-22. doi: 10.1097/ICU.0000000000001003. Epub 2023 Oct 19.
This review aims to clarify the advantages and disadvantages of immediately sequential bilateral cataract surgery (ISBCS) based on recent studies, illustrate the safety of this approach, the cost-effectiveness, and present the importance of inclusion protocols for the best results.
In recent studies, the authors found no evidence of an increased risk of bilateral devastating complications such as endophthalmitis with ISBCS based on descriptive evidence compared to delayed sequential bilateral cataract surgery (DSBCS). Furthermore, recent studies on cost analyses showed that ISBCS resulted in fewer costs and significant cost savings to third-party payers, patients, and society compared to DSBCS.
The ISBCS surgical approach decreases hospital visits, reduces costs, and provides rapid visual rehabilitation and neuro adaptation. The risk of bilateral simultaneous complications is now recognized to be very rare with intracameral antibiotics and compliance with correct protocols. With new generations of optical biometry and lens calculation formulas, refractive surprises are occasional for normal eyes. However, refractive surprise is controversial, especially in the implantation of presbyopia correction intra-ocular lenses, which must be evaluated carefully in the ISBCS approach.
本篇综述旨在基于最新研究，阐明立即序贯双侧白内障手术（ISBCS）的优缺点，说明该方法的安全性、成本效益，并强调纳入最佳结果的纳入方案的重要性。
在最近的研究中，与延迟序贯双侧白内障手术（DSBCS）相比，作者基于描述性证据发现，ISBCS 并没有增加双眼毁灭性并发症（如眼内炎）的风险。此外，最近关于成本分析的研究表明，与 DSBCS 相比，ISBCS 可减少成本并为第三方支付者、患者和社会带来显著的成本节约。
ISBCS 手术方法减少了医院就诊次数，降低了成本，并提供了快速的视力康复和神经适应。现在，随着眼内抗生素的应用和正确方案的遵守，双眼同时发生并发症的风险被认为非常罕见。然而，对于正常眼睛来说，屈光意外偶尔会发生，这在使用新一代的光学生物测量和人工晶状体计算公式时尤其如此。但是，屈光意外存在争议，特别是在植入治疗老视的人工晶状体时，在 ISBCS 方法中必须仔细评估。
