What is the role of bilateral same-day cataract surgery in your practice?

Like many things in medicine, sometimes there are mental hurdles to jump over that are more challenging than operational or evidence-based hurdles. We perform many invasive procedures, bilateral same day: laser vision correction, intravitreal injections, phakic IOLs, etc. Yet many of us, myself included, have some degree of reservation about same-day bilateral cataract surgery. The main reason I have not adopted this practice is due to reimbursement issues and ambulatory surgery center rules. If those two issues did not exist, I would be OK with bilateral same-day surgery if the patient elected to implant a monofocal lens. I still like the idea of being more conservative with multifocal lenses to make sure someone is generally satisfied wit...

We have been rolling out an Immediate Bilateral Cataract Surgery (ISBCS) program here at VA Boston and overall the results have been very favorable. We’ve done 80+ patients- enrollment has been slowed by strict inclusion criteria (even a tiny ERM will exclude them due to mild increased risk for pCME) and the difficulty of keeping the option on new residents’ and part-time attendings’ radars. Many times people are forgetting this option and it isn’t then offered. The results to date have been really excellent- very low rates of aborted 2nd eye surgeries (I think just 1 comes to mind). Patients are extremely happy with it, as it saves them half the number of trips to the hospital (which for many could be hours long drives) and more rapid reco...