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Immediate Sequential Bilateral Cataract Surgery: A Systematic Review and Meta-Analysis.

Kessel L, Andresen J, Erngaard D, Flesner P, Tendal B, Hjortdal J - J Ophthalmol (2015)

Bottom Line: The quality of evidence was rated as low to very low.In conclusion, we cannot provide evidence-based recommendations on the use of ISBCS due to the lack of high quality evidence.Therefore, the decision to perform ISBCS should be taken after careful discussion between the surgeon and the patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Rigshospitalet-Glostrup, 2600 Glostrup, Denmark ; Danish Health and Medicines Authority, 2300 Copenhagen S, Denmark.

ABSTRACT
The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery on two different dates. The quality of evidence was rated as low to very low. None of the studies reported the prevalence of postoperative anisometropia. In conclusion, we cannot provide evidence-based recommendations on the use of ISBCS due to the lack of high quality evidence. Therefore, the decision to perform ISBCS should be taken after careful discussion between the surgeon and the patient.

No MeSH data available.


Related in: MedlinePlus

Subjective visual function assessed using the VF-7 (Sarikkola) or VF-14 (Serrano-Aguilar) questionnaire 1 month after bilateral cataract surgery in patients randomized to immediate sequential bilateral cataract surgery (same-day surgery) or different date bilateral cataract surgery. CI: confidence interval. IV: inverse variance. SD: standard deviation.
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Related In: Results  -  Collection


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fig3: Subjective visual function assessed using the VF-7 (Sarikkola) or VF-14 (Serrano-Aguilar) questionnaire 1 month after bilateral cataract surgery in patients randomized to immediate sequential bilateral cataract surgery (same-day surgery) or different date bilateral cataract surgery. CI: confidence interval. IV: inverse variance. SD: standard deviation.

Mentions: All three included RCTs reported the subjective satisfaction with visual function postoperatively but one study did not report the standard deviation; therefore, we could not include it in the meta-analysis [23]. The remaining two studies [24, 25] evaluated visual function on two different scales (VF-7 and VF-14) and hence we used the standardized means method in order to include both the studies in the same meta-analysis. In the group randomized to bilateral surgery on two different days, subjective visual function was lower in the period between first and second eye surgeries. This effect disappeared when the second eye was operated on and 1-2 months after bilateral surgery there was no difference in subjective visual function between the groups randomized to ISBCS or surgery on two different days; see Figure 3. Since none of the studies was blinded, the quality of the evidence was rated as moderate; see Table 3.


Immediate Sequential Bilateral Cataract Surgery: A Systematic Review and Meta-Analysis.

Kessel L, Andresen J, Erngaard D, Flesner P, Tendal B, Hjortdal J - J Ophthalmol (2015)

Subjective visual function assessed using the VF-7 (Sarikkola) or VF-14 (Serrano-Aguilar) questionnaire 1 month after bilateral cataract surgery in patients randomized to immediate sequential bilateral cataract surgery (same-day surgery) or different date bilateral cataract surgery. CI: confidence interval. IV: inverse variance. SD: standard deviation.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4553313&req=5

fig3: Subjective visual function assessed using the VF-7 (Sarikkola) or VF-14 (Serrano-Aguilar) questionnaire 1 month after bilateral cataract surgery in patients randomized to immediate sequential bilateral cataract surgery (same-day surgery) or different date bilateral cataract surgery. CI: confidence interval. IV: inverse variance. SD: standard deviation.
Mentions: All three included RCTs reported the subjective satisfaction with visual function postoperatively but one study did not report the standard deviation; therefore, we could not include it in the meta-analysis [23]. The remaining two studies [24, 25] evaluated visual function on two different scales (VF-7 and VF-14) and hence we used the standardized means method in order to include both the studies in the same meta-analysis. In the group randomized to bilateral surgery on two different days, subjective visual function was lower in the period between first and second eye surgeries. This effect disappeared when the second eye was operated on and 1-2 months after bilateral surgery there was no difference in subjective visual function between the groups randomized to ISBCS or surgery on two different days; see Figure 3. Since none of the studies was blinded, the quality of the evidence was rated as moderate; see Table 3.

Bottom Line: The quality of evidence was rated as low to very low.In conclusion, we cannot provide evidence-based recommendations on the use of ISBCS due to the lack of high quality evidence.Therefore, the decision to perform ISBCS should be taken after careful discussion between the surgeon and the patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Rigshospitalet-Glostrup, 2600 Glostrup, Denmark ; Danish Health and Medicines Authority, 2300 Copenhagen S, Denmark.

ABSTRACT
The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery on two different dates. The quality of evidence was rated as low to very low. None of the studies reported the prevalence of postoperative anisometropia. In conclusion, we cannot provide evidence-based recommendations on the use of ISBCS due to the lack of high quality evidence. Therefore, the decision to perform ISBCS should be taken after careful discussion between the surgeon and the patient.

No MeSH data available.


Related in: MedlinePlus