Have you noticed your vision is more blurry, or night driving seems more difficult due to glare and starbursts from car headlights and other lights? Is this just ageing, or could it be the start of cataracts? If so, you’re not alone. Cataracts are one of the most common causes of visual decline with age, but the good news is that cataract surgery remains one of the safest and most successful procedures worldwide. And now, with modern advances, many patients can choose to have same-day bilateral cataract surgery, a convenient option whereby both eyes can be treated in just 30 minutes. But is it right for everyone?
At Mr Alex Day’s clinics in Moorfields Private, West London and Moorfields Private City, same day bilateral surgery is offered as well as the more traditional one eye at a time approach.
What Is Same-Day Bilateral Cataract Surgery?
Same-day bilateral cataract surgery, medically termed Immediate Sequential Bilateral Cataract Surgery (ISBCS), refers to performing cataract removal and lens replacement on both eyes in a single session. Traditionally, cataract operations are carried out separately, with a few weeks between each eye (termed Delayed Sequential Bilateral Cataract Surgery, DSBCS). Due to the current and ever-increasing safety of cataract surgery, there is now very strong evidence to support the safety and practicality of same-day treatment for appropriate patients. Indeed, the 2022 Cochrane Review concluded “Current evidence supports there are probably no clinically important differences in outcomes between ISBCS and DSBCS.”
What Is Same-Day Bilateral Cataract Surgery?
Same-day bilateral cataract surgery, medically termed Immediate Sequential Bilateral Cataract Surgery (ISBCS), refers to performing cataract removal and lens replacement on both eyes in a single session. Traditionally, cataract operations are carried out separately, with a few weeks between each eye (termed Delayed Sequential Bilateral Cataract Surgery, DSBCS). Due to the current and ever-increasing safety of cataract surgery, there is now very strong evidence to support the safety and practicality of same-day treatment for appropriate patients. Indeed, the 2022 Cochrane Review concluded that “current evidence supports there are probably no clinically important differences in outcomes between ISBCS and DSBCS” (Dickman et al., 2022).
What Are the Advantages of Same-Day Bilateral Cataract Surgery
- Both eyes are operated on, one at a time, in one visit.
- Reduced time off work and faster return to normal daily activities.
- Patients achieve binocular vision correction more quickly, without the imbalance that sometimes occurs when one eye is operated on before the other.
- Potential cost savings on interim spectacle updates between surgeries.
Who Is an Ideal Candidate for Same-Day Bilateral Cataract Surgery?
You may be a good candidate if:
- Both eyes are affected by cataracts similarly.
- You are in good general and ocular health.
- You prefer minimal downtime and fewer clinic visits.
Contraindications for same-day bilateral cataract surgery include:
- Those who need concomitant surgery for glaucoma, corneal or retinal problems.
- Previous significant eye surgery or significant eye injury, such as crystalline lens luxation or phacodonesis.
- Increased risk of post-operative corneal failure (e.g. Fuchs’ endothelial dystrophy).
- Those at increased risk of infection, such as chalazion, active blepharitis, lid position issues, or any conjunctivitis.
- Patients with ocular co-morbidity such as recurrent uveitis, pseudoexfoliation, poorly controlled glaucoma or significant diabetic retinopathy.
- Previous refractive surgery, especially if the patient still prefers spectacle independence.
- Iodine allergy.
Book your consultation with Alex Day to determine your suitability for same-day bilateral cataract surgery.
Are There Any Drawbacks to Same-Day Bilateral Cataract Surgery to Consider?
The two main drawbacks to consider are that, in same-day bilateral cataract surgery, there is no opportunity to fine-tune the intraocular lens (IOL) power for the second eye, and there remains a very small risk of infection occurring in both eyes following surgery (known as bilateral endophthalmitis).
Whilst lens power calculations are now extremely accurate at predicting the optimal lens for sharp vision, there will always be occasional outcomes that differ slightly from what was expected. For patients who have a strong preference for the most precise vision possible without glasses, this could be a potential drawback, as there is no chance to adjust the second eye’s IOL power based on the first eye’s result.
However, using modern intraocular lens calculation methods—such as those routinely used by Mr Alex Day—the 2023 BICAT-NL study, a Dutch multicentre randomised controlled trial comparing immediate and delayed sequential bilateral cataract surgery, found no difference in the proportion of second eyes achieving good unaided visual acuity or refractive accuracy. This was despite surgeons in the study being allowed to adjust the lens power for the second eye based on the first eye’s outcome (Spekreijse et al., 2023).
The other main concern in immediate sequential bilateral cataract surgery (ISBCS) is the risk of an infection developing in both eyes following surgery. In ISBCS, meticulous protocols are followed to ensure that sterile surgical techniques are completely separated between eyes, minimising any chance of cross-contamination. According to Moorfields Eye Hospital, the additional risk of severe and permanent vision loss in both eyes from undergoing same-day surgery, rather than procedures spaced a few weeks apart, is estimated to be approximately 1 in 250,000 (Moorfields Eye Hospital, 2023).
How Same-Day Cataract Surgery Works
Step-by-Step Overview
- Comprehensive Pre-Operative Assessment – An in-depth eye examination determines visual needs, eye health, and suitability for same-day treatment.
- Phacoemulsification Surgery – Each eye is operated on separately with different instruments, sterile drapes, and surgical products.
- Lens Implant Placement – An advanced IOL is inserted to restore clear vision.
- Recovery – Patients rest briefly post-surgery and return home the same day.
Discover more about Cataract Treatment in London and explore whether you’re eligible for this efficient approach.
Recovery Expectations After Same-Day Surgery
Immediate Post-Surgery Period
- Mild discomfort, tearing, or light sensitivity are common for the first 24 to 48 hours.
- Protective shields are worn overnight.
- Antibiotic and anti-inflammatory drops are prescribed for both eyes.
Return to Daily Activities
- Most patients can return to their normal activities within 24 to 48 hours.
- Driving is typically permitted once vision meets legal standards, usually within a week.
- Light exercise can resume after one week.
Visual Results
- Noticeable vision improvement is typically seen within 1–3 days.
- Final clarity continues to sharpen over several weeks as both eyes and the brain adjust to the new lenses.
For more details, explore Post-Operative Care Guidelines or message the clinic on WhatsApp for personalised recovery advice.
Final Thoughts: Is Same-Day Bilateral Cataract Surgery Worth It?
For suitable patients, same-day cataract surgery offers a faster, more convenient route to clear vision.
If you’re considering treatment, trust your eyes to Mr Alex Day, Consultant Ophthalmic Surgeon at Moorfields Private London, specialising in cataract and lens replacement surgery with a personalised, patient-first approach.
📞 Call: 020 7100 5468
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📅 Book Your Consultation
FAQs
1. Can I have cataract surgery on both eyes at once?
Yes, this is known as immediate sequential bilateral cataract surgery (ISBCS), where both eyes are treated safely on the same day by using separate sterile equipment.
2. Is same-day cataract surgery safe for older patients?
In most cases, yes. As long as overall eye health is stable, same-day surgery can be a suitable and efficient option for older adults.
3. How long does recovery take for both eyes?
Most patients regain good vision within a few days, with full recovery over several weeks.
4. What are the side effects of same-day bilateral cataract surgery?
Mild discomfort, temporary blurring, or glare are common early on, but serious complications are rare with modern sterile techniques.
5. How soon can I drive after the procedure?
Once both eyes meet the DVLA’s legal vision standard, typically within several days, but always confirm with your surgeon first.
References
- Dickman MM, Spekreijse LS, Winkens B, Schouten JS, Simons RW, Dirksen CD, Nuijts RM. Immediate sequential bilateral surgery versus delayed sequential bilateral surgery for cataracts. Cochrane Database Syst Rev. 2022 Apr 25;4(4):CD013270. doi:10.1002/14651858.CD013270.pub2. PMID: 35467755; PMCID: PMC9037598.
- Spekreijse L, Simons R, Winkens B, van den Biggelaar F, Dirksen C, Bartels M, de Crom R, Goslings O, Joosse M, Kasanardjo J, Lansink P, Ponsioen T, Reus N, Schouten J, Nuijts R. Safety, effectiveness, and cost-effectiveness of immediate versus delayed sequential bilateral cataract surgery in the Netherlands (BICAT-NL study): a multicentre, non-inferiority, randomised controlled trial. Lancet. 2023 Jun 10;401(10392):1951–1962. doi:10.1016/S0140-6736(23)00525-1. Epub 2023 May 15. PMID: 37201546.
- Moorfields Eye Hospital. Cataract Service Patient Information Leaflet. London: Moorfields Eye Hospital NHS Foundation Trust; 2023. Available from: https://www.moorfields.nhs.uk/mediaLocal/ojzfucri/cataract-service_1.pdf
