Double cataract surgery is better for patients, studies suggest

Patients could safely be given double cataract surgery and may even recover more quickly if both eyes are operated on at the same time, new research suggests.

People who need double cataract surgery usually have an operation on one eye and receive treatment for the second eye several weeks later to allow the recovery of one eye at a time.

While double surgery can be performed, it is more common for cataract procedures to be conducted separately, with the worst-affected eye usually treated first.

Cataracts are diagnosed when the lens in the eye becomes cloudy. This causes blurred vision and loss of sight.

New research, published at the Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), suggests surgery can be performed safely and effectively on both eyes on the same day.

One study concluded that double cataract surgery, also known as simultaneous bilateral cataract surgery, “enables a rapid return to self-sufficiency, thereby reducing the overall burden on caregivers”.

Researchers from Denmark surveyed around 70 patients and found that most regained self-sufficiency “immediately” after they arrived home.

But they highlighted that a “significant portion” of patients benefit from having a caregiver present during the first day after the operation.

The author of the study, Mia Vestergaard Bendixen, an ophthalmic nurse from Silkeborg Regional Hospital, said: “Our results show that many people can expect to manage well soon after surgery, which may ease anxiety about needing support. However, some still benefit from a caregiver during the first day.

“If surgery can be carried out in one go, this could reduce clinic visits and caregiver burden, as well as improving efficiency in healthcare delivery.”

A second study, published by experts at Moorfields Eye Hospital in London, compared outcomes among patients fitted with different types of lenses – monofocal, which provide sharp vision at one distance, or multifocal lenses, which split light to allow focus at multiple distances, aiming to reduce the need for reading or distance glasses.

They analysed more than 5,800 patients who received cataract surgery during 2023 at the eye hospital – some of whom had same-day surgery while others received separate treatment for each eye.

Researchers assessed various different measures of vision after the surgeries were performed.

Patients receiving multifocal lenses with same-day surgery achieved the best overall visual outcomes, the authors said.

“For patients, these findings are encouraging,” said Dr Gabriele Gallo Afflitto, from Moorfields Eye Hospital NHS Foundation Trust

“They suggest that having cataract surgery performed in both eyes on the same day, particularly when combined with multifocal lens implantation, can deliver excellent vision, reduce dependence on glasses, and allow faster recovery.”

Commenting on the studies, Dr Joaquin Fernandez, secretary for the ESCRS, said: “Taken together, these two studies show that cataract surgery to both eyes in one session can be performed safely, with patients recovering well at home and, crucially, achieving visual outcomes as good as or better than when surgery is performed in two steps.”

He added: “There are many potential advantages to treating cataracts in both eyes in one go.

“Not only does it reduce hospital visits for patients, it also saves time for hospital staff, potentially allowing them to see more patients.”