Ophthalmologists' attitudes toward immediate sequential bilateral cataract surgery: Dutch national survey

PURPOSE: To evaluate current practice patterns of immediate sequential bilateral cataract surgery (ISBCS) in the Netherlands and assess ophthalmologists' attitudes towards performing ISBCS in future cataract care.

SETTING: Dutch ophthalmic society members.

DESIGN: Cross-sectional study (national survey).

METHODS: An electronic survey on ISBCS was sent as part of an annual survey on cataract practice patterns to members of the Dutch ophthalmic society. Questions regarding current ISBCS practice patterns, willingness to perform ISBCS routinely in future care, reasons for performing ISBCS and reasons for not performing ISBCS were included. Data were analysed using descriptive statistics.

RESULTS: In total, 237/520 survey recipients (45.6%) responded to the overall survey. Data on the ISBCS questions was available from 227 respondents. Sixty-two ophthalmologists (27.3%) currently performed ISBCS, predominantly in low patient-volumes (90.3% in one to five patients per month). However, 108/227 ophthalmologists (47.6%) considered performing ISBCS routinely in future practice. Procedures for which ISBCS was mainly considered included age-related cataract surgery using topical and general anaesthesia. Availability of separate products and instruments for both eyes and patient advantages were considered of high importance when performing ISBCS. Main reasons for not performing ISBCS included the risk of endophthalmitis and potential medico-legal aspects.

CONCLUSIONS: Although ISBCS is currently no routine procedure in the Netherlands, it is considered by almost 50% of surgeons. In order to improve implementation on a national level, potential barriers identified in this survey (fear of bilateral endophthalmitis, potential medico-legal issues, a lack of availability of separate products for both eyes) should be addressed.