Same-day Bilateral Cataract Surgery Not Associated with Increased Risk of Endophthalmitis

Carim Dr. Leah Wartluft, ophthalmologist, prepares a patient for cataract surgery using the new ORA system at Carim Eye and Retina Center, 260 Westview Drive, Wyomissing. Photo by Bill Uhrich 7/1/2019 (Photo By MediaNews Group/Reading Eagle via Getty Images)
Study looks into concerns regarding complications of the surgical option.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 meeting of The Association for Research in Vision and Ophthalmology (ARVO), held virtually from May 1 to 7, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the eye and vision experts at ARVO. Check back for more from the ARVO 2021 Meeting.


For patients who underwent same-day bilateral cataract surgery, rates of postoperative endophthalmitis were similar to reports of those who underwent a single procedure, and the rates of bilateral endophthalmitis was also low, according to a poster presented at the Association for Research in Vision and Ophthalmology (ARVO) 2021 Annual Meeting, held virtually May 1 to May 7.

The poster, a retrospective observational study, examined if same-day bilateral cataract surgery is associated with an increased risk of endophthalmitis. It looked at 5,573,639 IRIS® Registry patients who underwent cataract surgery from 2013 to 2018 to determine the rate of endophthalmitis at 2 weeks of surgery. Of those, 165,609 (3%) had same-day bilateral cataract surgery and 5,408,030 (97%) had unilateral or delayed sequential bilateral surgery.

Researchers used multivariable logistic regression models to assess endophthalmitis risk associated with same-day surgery adjusting for the following: age, sex, insurance type, and history of common eye disease (age-related macular degeneration, diabetic retinopathy, and glaucoma). Investigators also assessed if the listed covariates were associated with different risks of endophthalmitis in the two groups. They identified potential cases of bilateral endophthalmitis, reviewing records of patients to confirm if endophthalmitis was bilateral.

They found that 3083 (0.055%, 95%CI [0.053, 0.057]) patients developed postoperative endophthalmitis and of those, 74 (0.045% [0.035, 0.056]) had same-day surgeries and 3,009 (0.056% [0.054, 0.058]) had unilateral or delayed bilateral surgery. They found six (0.0001%) cases of bilateral endophthalmitis—all of which occurred in the delayed sequential group.

“Same-day bilateral cataract surgeries were not associated with increased risk of postoperative endophthalmitis (OR: 0.79[0.60, 1.01]). The risk profile of postoperative endophthalmitis was similar between the two surgery groups,” researchers report. 

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Lacy M, Owen J, Yanagihara RT, et al. Endophthalmitis risk following same-day vs delayed sequential bilateral cataract surgery using the Intelligent Research in Sight (IRIS)® Registry. Poster presented at: The Association for Research in Vision and Ophthalmology (ARVO) 2021 Annual Meeting; May 1-7; Virtual. Abstract 3531450.