Current Status of Bilateral Same-day Cataract Surgery

Kendall E. Donaldson, MD, MS


Int Ophthalmol Clin. 2016;56(3):29-37. 

In This Article

Current Trends and Acceptance of Bilateral Same-day Surgery

Bilateral same-day cataract surgery has become a topic of controversy over the past several years, particularly with the increased focus on refractive procedures such as clear lens extraction and phakic intraocular lenses (IOLs). Patient expectations have risen as they have come to expect an almost instant and complete correction of vision with their intraocular surgical procedure, comparable with corneal refractive procedures.

Interestingly, bilateral same-day cataract surgery has always been accepted in veterinary medicine and in children born with bilateral congenital cataracts. It has become a common practice in several areas around the world, including countries such as Finland and Sweden.[1] It has also been accepted in situations involving some of our highest risk patients such as small children, mentally challenged, and the demented elderly that require general anesthesia. According to the 2015 ASCRS Clinical Survey of over 2000 members of the American Society of Cataract and Refractive Surgeons (ASCRS), over 70% of cataract surgeons around the world responded that they do not practice bilateral same-day surgery.[2] In the United States, nearly 80% responded that they never practice bilateral same-day surgery.[2] Totally, 11% of surgeons reported that they consider it under extenuating circumstances, and a smaller percentage of respondents report that they consider it for patient convenience.[2]

In recent years, The Kaiser Permanente System in California and Colorado has been practicing bilateral same-day cataract surgery and has altered their reimbursement patterns to encourage surgeons to pursue this option with their patients. However, most cataract surgeons practicing in the United States will face barriers with insurance and malpractice carriers when attempting bilateral simultaneous surgery in most ordinary surgical situations.