Björn JohanssonDepartment of Ophthalmology, Linköping University Hospital

Rationale for ISBCS(immediate sequential bilateral cataract surgery)

Conflict of interest: Bausch&Lomb, AMO, Zeiss, iSBCS

Why?

• Fast rehabilitation

• Avoid anisometropia and other binocular disturbances

• Decrease worry

Why?

• Utilise limited health care resources optimally

• Lundström et al, Acta Ophthalmol Scand 2009

• Decreased costs for society (transports, support staff etc)

Research platform

• Patient serves as control• Fast inclusion• Effective follow-up• Motivated patients

Research platform

• Intraocular lens studies, e. g.

Multifocal IOLs

Different IOL designs• PCO• Quality of vision

• Topical therapy studies, e.g.

Comparison between different drugs

Effects of preservatives

Indications (absolute/relative)

• Bilateral cataract that is expected to create difficulties if treated with unilateral surgery

• Expected anisometropia after unlateral surgery

• Wish for fast rehabilitation • Activity level• General disease (balance disorder, mobility

problems etc)• Social situation (living alone, need for

assistance etc)• Fear of surgery(!)

Exclusion criteria (absolute/relative)

• Patient hesitating• Uncertain quality of postoperative care• Eye pathology or general disease that

increases complication risk• Difficult prediction of postoperative refraction• Large difference in cataract density between

eyes• Complication at first surgery

Finally, don’t forget…

• It IS possible to manage with one only…