Immediate sequential bilateral surgery versus delayed sequential bilateral surgery for cataracts: Protocol

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: Primary objective To assess the safety of immediate sequential bilateral cataract surgery (ISBCS) compared to delayed sequential bilateral cataract surgery (DSBCS) in patients with bilateral age-related cataracts. To summarise current evidence for the incremental resource use, utilities, costs and/or cost-effectiveness associated with the use of ISBCS compared to DSBCS in patients with bilateral age-related cataracts. Secondary objective To assess visual and patient-reported outcomes of ISBCS compared to DSBCS in patients with bilateral age-related cataracts. B A C K G R O U N D Description of the condition An age-related cataract is characterised by gradual clouding of the crystalline lens. In 2015, un-operated cataracts accounted for 35% of blindness worldwide, indicating that this vision-impairing condition was the leading cause of preventable blindness (Bourne 2017). In the majority of cases, ARC affects both eyes, referred to as bilateral cataracts (Neel 2014). In contrast to unilateral cases, bilateral cataracts are more likely to cause significant problems in daily activities, such as reading and face recognition, negatively impacting quality of life (QoL) in older people (Harrer 2013; Zuo 2015). In addition, patients are more likely to be placed in nursing homes and suffer from falls, resulting in fractures and increased mortality (Chew 2012). Compared to unilateral cases, bilateral cataracts also negatively affect vision-specific functions. Treatment of both eyes has been shown to result in higher patient satisfaction, and greater improvement of visual acuity and vision-related QoL compared to treating only one eye (Chew 2012; Shekhawat 2017).