- Title Information
- Title
- Characteristics of Immediate Sequential Bilateral Cataract Surgery in the United States Department of Veterans Affairs
- Type of Resource (primo)
- text_resources
- Abstract
- Purpose: Benefits of immediate sequential bilateral cataract surgery (ISBCS) include lower cost, expedited visual rehabilitation, and fewer appointments. However, ISBCS is not widely performed in the U.S. due to concerns of bilateral infections and reimbursement policies. We conducted a retrospective study to compare characteristics and surgical outcomes of immediate versus delayed sequential bilateral cataract surgery (DSBCS).
Methods: Using the VA Informatics and Computing Infrastructure (VINCI), we identified cataract surgery patients via Current Procedural Terminology (CPT) codes (66984, 66982). We included patients who underwent ISBCS or DSBCS between January 1, 2004, and January 1, 2024, under topical anesthesia. We defined ISBCS as both surgeries conducted on the same day and DSBCS as the two surgeries conducted within a 14-day interval. Patients who received general anesthesia or regional blocks were excluded. A manual chart review was performed to validate ISBCS cases and complications for ISBCS and DSBCS. Complications were defined as postoperative endophthalmitis or return to the operating room within 90 days of surgery.
Results: A total of 47,892 patients met the inclusion criteria; 1,151 (2.4%) received ISBCS and 46,741 (97.6%) DSBCS. There were no significant differences in mean age (p=0.065) or sex distribution (p=0.853) between the two groups. ISBCS patients had a greater travel burden (p<0.001) and fewer ocular comorbidities (p < 0.001). Systemic comorbidities, measured by the Charlson Comorbidity Index, did not differ (p = 0.086) between the two groups. ISBCS was more likely to occur at higher-volume centers (p = 0.008) and less likely when residents were primary surgeons (p < 0.001). There was no significant difference in postoperative complication rates between the two groups (p = 0.565).
Conclusions: ISBCS patients were more likely to have fewer ocular comorbidities, travel longer distances, and undergo surgery at high-volume centers. The rate of complications was similar between the ISBCS and DSBCS patient groups. Future research should investigate the underlying reasons for the low utilization of ISBCS within the VA.
- Name
- Name Part
- Kang, Chaerim
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Zhu, Angela
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Kashner, Michael
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Oetting, Thomas
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Morhun, Patrick
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Greenberg, Paul
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name:
Corporate
- Name Part
- Brown University. Alpert Medical School. Scholarly Concentration Program. Aging
- Role
- Role Term:
Text
- research program
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00848903")
- Topic
- Cataract--Surgery
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01046503")
- Topic
- Ophthalmology
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00848909")
- Topic
- Cataract--Treatment
- Language
- Language Term:
Text (ISO639-2B)
- English
- Origin Information
- Date Created
(keyDate="yes", encoding="w3cdtf")
- 2025
- Note
(displayLabel="Scholarly concentration")
- Aging
- Access Condition:
use and reproduction
- All rights reserved
- Access Condition:
rights statement
(href="http://rightsstatements.org/vocab/InC/1.0/")
- In Copyright
- Access Condition:
restriction on access
- All Rights Reserved
- Identifier:
DOI
- 10.26300/dj4q-pm87