Eyeworld

20 | EYEWORLD | APRIL 2023 ASCRS NEWS EYEWORLD JOURNAL CLUB by Steven Carrubba, MD, and Sheel R. Patel, MD New York University Langone Health ophthalmology residents >2 diopters, and certain disease states (e.g., diabetic macular edema, moderate to severe glaucoma, Fuchs dystrophy, uveitis, etc.). The primary endpoint was the uncorrected distance visual acuity (UDVA), measured at office visits on postoperative day 0 (POD0) or 1 (POD1), week 1 (POW1), and month 1 (POM1). Visual acuity was measured via Snellen chart as a frac- tion relative to 20/20; a given line was counted when a patient could correctly read at least 3 of the 5 letters on that line. These data points were compared with the preoperative corrected distance visual acuity (CDVA) of each or both eyes, which represented the patient's baseline. Results Of the 116 patients (232 eyes) who were stud- ied, 69 (138 eyes) underwent initial postoper- ative assessment on POD0 and 47 (94 eyes) on POD1. All eyes were subsequently evaluated on POW1 and POM1. Compared to their preoper- ative CDVAs, 48% (66/138) of eyes by POD0, 79% (74/94) by POD1, and 90% (209/232) by POW1 demonstrated stable or improved UDVAs. Eighty-seven percent (201/232) of eyes achieved these results by POM1. After excluding eyes with baseline vision of 20/30 or better, analysis revealed that 64% (58/90) of eyes by POD0, 87% (61/70) by POD1, 98% (157/160) by POW1, and 95% (152/160) by POM1 demonstrated stable or improved acuities. These results translated to 83% of individuals achieving a stable or improved acuity in their Review of "Visual recovery after immediate sequential bilateral cataract surgery at a veterans' hospital" I mmediate sequential bilateral cataract surgery (ISBCS) refers to bilateral cataract extractions performed in the same sitting but as separate, consecutive procedures. Although first performed in the 1950s, 1 the practice has become increasingly implemented by some countries (e.g., Finland, Sweden, and Canada) as an alternative to traditional delayed sequential bilateral cataract surgery (DSBCS), 2,3 which temporally separates operations between eyes. ISBCS has generated controversy among practitioners. Those in favor cite reduced ex- penses and fewer office visits for patients and providers, as well as faster overall optical reha- bilitation. 2 Those opposed argue that the risk of bilateral endophthalmitis and refractive sur- prises are unjustified. 2 The potential benefits of ISBCS have also increased interest and inquiry among patients, particularly after the COVID-19 pandemic. 4–6 One retrospective study demon- strated that as many as 90% of patients who underwent the procedure would recommend it to their friends and relatives. 7 However, areas of uncertainty among patients considering ISBCS include their expected time to visual recovery and functional status immediately following sur- gery. 6 In the article presently reviewed, Kwedar et al. track the short-term postoperative visual acuities of patients who underwent ISBCS to formulate a timeline for visual recovery. Methods The authors conducted a retrospective chart review of consecutive patients who underwent ISBCS (emmetropic target) between January and December 2019 at the Harry S. Truman Memorial Veterans' Hospital. A total of 116 patients (232 eyes) were identified for inclu- sion. These patients had all originally passed a screening to qualify for ISBCS, which exclud- ed individuals with dense cataracts (i.e., 3+ nuclear sclerotic, white, or posterior polar), prior refractive surgery, extremes of axial length (<22 mm or >25 mm), irregular astigmatism Leela Raju, MD Clinical Associate Professor Department of Ophthalmology New York University Lagone Health New York, New York Contact Carrubba: steven.carrubba @nyulangone.org Patel: sheel.patel@nyulangone.org EyeWorld Journal Club review Sheel R. Patel, MD, and Steven Carrubba, MD Source: New York University Langone Health continued on page 22

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