Is it time for a new attitude to “simultaneous” bilateral cataract surgery?

SUMMARY

Almost every discussion on simultaneous bilateral cataract surgery (SBCS) for senescent cataracts begins with a comment on its controversial nature.1–3 The question is can the benefits of bilateral surgery justify the risk of
simultaneous bilateral complications, in particular endophthalmitis? Operating on the second eye immediately after the first is an option that does have potential advantages. These can be separated into the clinical benefits to the patient and economic benefits to the patient, hospital, and society. It is the benefits and risks to the patient that are our primary duty as clinicians, and they will be the focus of this discussion. In this perspective we present an approach to “simultaneous” bilateral cataract extraction,
and examine the risk of unilateral or bilateral complications following cataract extraction in light of the perceived benefits as they apply at the beginning of the 21st century. The aim of the perspective is to remove the stigma from “simultaneous” bilateral cataract surgery, so that suitable patients may be offered this method of delivery of treatment.