For a study, researchers sought to find out how often immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS) were, as well as the variables that led to ISBCS. From 2011 to 2019, Medicare participants aged 65 underwent ISBCS and DSBCS. Analysis of 100% Medicare fee-for-service carrier claims data using a population-based approach. To assess parameters linked to ISBCS, logistic regression models were used. ISBCS and DSBCS rates, demographic, ocular, and medical features linked with ISBCS, and endophthalmitis and cystoid macular edema (CME) rates following ISBCS and DSBCS.
A total of 4014 (0.2%) ISBCS patients and 1,940,965 (99.8%) DSBCS patients were found. Patients who were Black (OR 2.31; 95% CI, 2.06–2.59), Asian (OR 1.82; 95% CI, 1.51–2.19), or Native American (OR 2.42; 95% CI, 1.81–3.23) were more likely than White patients to get ISBCS. Patients in rural locations had a greater risk of developing ISBCS (OR, 1.26; 95% CI, 1.17–1.35) than those in urban areas. Patients receiving surgery in a hospital were more likely to get ISBCS than those undergoing surgery in an ambulatory environment (OR, 2.71; 95% CI, 2.53–2.89). Patients with bilateral complicated versus noncomplex cataracts were more likely to get ISBCS (OR, 3.23; 95% CI, 2.95–3.53). Patients with a Charlson comorbidity index (CCI) of 1 to 2 (OR, 1.45; 95% CI, 1.29–1.62), 3 to 4 (OR, 1.70; 95% CI, 1.47–1.97), 5 to 6 (OR, 1.97; 95% CI, 1.62–2.39), and CCI 7 (OR, 1.97; 95% CI, 1.55–2.50) were more likely to receive ISBCS than those with a C Patients with glaucoma (OR: 0.82; 95% CI: 0.76–0.89), macular degeneration (OR: 0.75; 95% CI: 0.68–0.82), and macular hole or epiretinal membrane (OR: 0.55; 95% CI: 0.48–0.65) were less likely than those without to have ISBCS. Between ISBCS (1.74 per 1000 ISBCS procedures) and DSBCS (1.01 per 1000 DSBCS procedures; P=0.15), no significant difference in endophthalmitis rates within 42 days was identified. Similarly, there was no significant difference in CME rates between ISBCS (1.79 per 100 operations) and DSBCS (P=0.45). (1.96 per 100 DSBCS procedures). Although the incidence of endophthalmitis and CME were comparable to DSBCS, overall utilization of ISBCS among Medicare enrollees remained low over the last decade. Receiving ISBCS was linked to race, region, and systemic and ocular comorbidities. ISBCS might help to increase access to cataract surgery.
Reference:www.aaojournal.org/article/S0161-6420(21)00965-9/fulltext
