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Brandon J Baartman, Yuan Cao, Alex Yuan, Richard Gans; Comparison of unilateral versus bilateral cataract surgery rates. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1922.
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To determine what percentage of patients at the Cleveland Clinic underwent cataract surgery on only one eye during a two-and-a-half year follow-up period.
A retrospective chart review was performed in accordance with Cleveland Clinic IRB policy. Electronic medical records of patients treated at the Cleveland Clinic from January 1, 2012 to August 1, 2014 were searched using CPT codes for cataract surgery (66984 and 66982). Those surgeries associated with duplicate Medical Record Numbers (MRNs) were considered bilateral cases, whereas surgeries with unique MRNs were counted as single-eye cases.
From January 1, 2012 to August 1, 2014, there were 26,363 cataract surgeries performed at the Cleveland Clinic. Of these cases, 20666 had duplicate MRNs, representing 10333 patients with bilateral surgery. The remaining 5,697 cases were unilateral (36%).
Cataract surgery, often thought of as a bilateral procedure, is most often performed as a “delayed sequential cataract surgery”. This standard of care in the United States involves performing the second cataract surgery days to months following completion of the first1. Some surgeons have advocated performing bilateral, same-day cataract surgery, or “immediate sequential cataract surgery”1,2. We wanted to know the rate of unilateral cataract surgery at our institution. Our study demonstrates that cataract surgery was performed on one eye in 36% of cases at the Cleveland Clinic over a two and a half year timeframe. Although we cannot exclude the possibility that some of these patients had second-eye surgery outside this time frame, this finding is surprising given the trends in practice for most ophthalmologists, and warrants further analysis into the possible reasons resulting in a decision to perform unilateral surgery.<br /> <br /> 1. Neel ST. A cost and policy analysis comparing immediate sequential cataract surgery and delayed sequential cataract surgery from the physician perspective in the United States. JAMA Ophthalmol. 2014; 132(11):1359-1362.<br /> 2. Lundstrom M, Albrecht S, Roos P. Immediate versus delayed sequential bilateral cataract surgery: an analysis of costs and patient value. Acta Ophthalmol. 2009; 87(1):33-8.
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