Safety and efficacy of a novel ‘One-Visit, Both-Cataracts’ high-volume see-and-treat immediate sequential bilateral cataract surgery service in a public healthcare setting

TL;DR

A new one-visit cataract surgery method was tested and found to be safe and efficient in a public hospital.

Contribution

Introduces a streamlined one-visit model combining see-and-treat with immediate bilateral cataract surgery.

Findings

84.3% of patients completed the one-visit surgery with no intraoperative complications.

Low complication rates, including 2.9% cystoid macular oedema and no visual loss or endophthalmitis.

The model saves time and resources while maintaining patient safety.

Abstract

To evaluate the safety and efficacy of a novel cataract surgery pathway that combines a See-and-Treat (S&T) model with Immediate Sequential Bilateral Cataract Surgery (ISBCS) at the Nightingale Hospital, Exeter, UK.

A retrospective observational study was conducted on 102 consecutive patients (204 eyes) who underwent S&T ISBCS between July 2023 and July 2024. Patients were triaged based on referral information and underwent preoperative telephone consultations. On the day of surgery, clinical assessment and bilateral cataract surgery were completed in a single visit. Data collected included patient demographics, intraoperative and postoperative outcomes, and complications.

Of the 127 patients listed, 102 (84.3%) completed S&T ISBCS. No intraoperative complications were recorded. Fourteen patients (13.7%) required unplanned postoperative consultations, with most cases being non-sight-threatening and self-resolving. Cystoid macular oedema (CMO) was reported in 2.9% of eyes, with no cases of visual loss or endophthalmitis.

The S&T ISBCS model demonstrated safety and efficiency in delivering cataract care, with a high one-visit completion rate and low complication rates. This model offers significant time and resource savings whilst maintaining patient safety. It holds potential for broader implementation in healthcare settings facing increased demand for cataract services. Further studies are recommended to assess long-term outcomes and optimise this approach.

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