The results of two new studies – presented at the 43rd Congress of the European Society of Cataract and Refractive Surgeons (ESCRS) – show it can be safe, effective, and practical for most patients to have cataract surgery on both eyes in one day.
The first study, by Danish researchers, shows that most patients can manage at home on their own after cataract surgery on both eyes, and carry out essential tasks such as preparing food and using their mobile phone.1
The second study, by researchers from the United Kingdom, shows that patients receiving same-day cataract surgery on both eyes achieved visual outcomes as good as, or even better than those receiving treatment in two separate surgical procedures.2
Cataract surgery is one of the most common surgical procedures worldwide and cataracts often affect both eyes.
Traditionally, when both eyes require cataract surgery, they are operated on separately, often weeks or months apart, a practice called delayed sequential bilateral cataract surgery.
Increasingly, surgeons are offering immediate sequential bilateral cataract surgery, where both eyes are operated on during the same surgical session. But questions remain about whether this is as accurate and effective as delayed surgery, and how patients cope with day-to-day life immediately after surgery.
Need for Home Assistance After Surgery
The Danish researchers, from Silkeborg Regional Hospital and Aarhus University Hospital, asked 157 patients who had undergone cataract surgery on both eyes on the same day to complete a questionnaire about their need for assistance immediately after they arrived home from surgery and again 24 hours later. A total of 72% of patients responded.
The survey results showed 88% of patients could find their way around the home independently, 79% managed to prepare food, 51% did not need help using their mobile phone, when they arrived home following surgery. Sixty-two percent said they did not need a caregiver at all in the first 24 hours.
However, 51% still needed help to use their eye drops.
Ophthalmic nurse Mia Vestergaard Bendixen from Silkeborg Regional Hospital said: “There is very little research on patients’ self-sufficiency immediately after cataract surgery on both eyes in one day. Our results show that many people can expect to manage well soon after surgery, which may ease anxiety about needing support. “However, some still benefit from a caregiver during the first day. For clinicians, these findings support offering same-day cataract surgery, while emphasising patient education and planning for temporary help if needed. If surgery can be carried out in one go, this could reduce clinic visits and caregiver burden, as well as improving efficiency in healthcare delivery.”
Visual Results Comparison
The UK study, one of the largest of its kind, was carried out at Moorfields Eye Hospital NHS Foundation Trust in London. It included 10,192 patients having cataract surgery on both eyes at the hospital between December 2023 and December 2024.
Most were having delayed sequential bilateral cataract surgery (DSBCS), others were having immediate sequential bilateral cataract surgery (ISBCS). Some patients were having monofocal intraocular lenses (IOLs), and others were having multifocal IOLs.
The researchers analysed several different measures of vision in the patients following surgery, including whether they achieved excellent results, defined as 20/20 vision or better and a glasses prescription at or very near the intended target.
having cataract surgery performed in both eyes on the same day, particularly when combined with multifocal lens implantation, can deliver excellent vision, reduce dependence on glasses, and allow faster recovery
Patients receiving multifocal IOLS with same-day surgery achieved the best overall visual outcomes, with 85% achieving 20/20 vision or better. In patients who received monofocal IOLs, around 70% achieved 20/20 vision, regardless of whether they had surgery in both eyes on the same day or on different days. For patients having surgery on different days with multifocal IOLS, the figure was 77%.
In terms of prescription accuracy, 88% of multifocal same-day patients were very near the target (within ±0.5 dioptres), while 67% of patients achieved this in the monofocal delayed group and 71% in the monofocal same-day group. All (100%) of multifocal patients were near the target (within ±1.0 dioptre), regardless of whether they had surgery in both eyes on the same day, or on different days.
The improved outcomes for multifocal same-day surgery remained even when researchers adjusted for patient age, gender, and the surgeon’s level of experience.
Dr Gabriele Gallo Afflitto from Moorfields Eye Hospital NHS Foundation Trust said: “For patients, these findings are encouraging. They suggest that having cataract surgery performed in both eyes on the same day, particularly when combined with multifocal lens implantation, can deliver excellent vision, reduce dependence on glasses, and allow faster recovery.”
Mr Vincenzo Maurino, a consultant ophthalmic surgeon at Moorfields Eye Hospital NHS Foundation Trust, added: “For the patients and the hospital, this approach offers potential efficiency gains, including reduced waiting time, faster visual rehabilitation, and fewer clinic appointments, as well as reduced waiting time and lower overall costs, all without compromising patient outcomes.”
Commenting on the studies, ESCRS Secretary Dr Joaquín Fernández, who was not involved in the research, said that “taken together, these two studies show that cataract surgery to both eyes in one session can be performed safely, with patients recovering well at home and, crucially, achieving visual outcomes as good as, or better, than when surgery is performed in two steps. This should reassure patients, their families, and their surgeons that safety is not compromised”.
References
- Vestergaard Bendixen M, et al. Recovery of self-sufficiency and need for assistance after simultaneous bilateral cataract surgery, ESCRS25-ESONT-2746, ESONT Presented Poster, ESCRS; 2025 Sept 13; Copenhagen, Denmark. Available at: pag.virtual-meeting.org/escrs/escrs2025/en-GB/pag/presentation/572613.
- Gallo Afflitto G, et al. Immediate vs. delayed sequential bilateral cataract surgery: visual and refractive outcomes in mono- vs. multifocal intraocular lens implantation’ ESCRS25-FP-2631. Presented in the session: Advanced monofocal and EDF IOLs, ESCRS; 2025 Sept 14; Copenhagen, Denmark. Available at: pag.virtual-meeting.org/escrs/escrs2025/en-GB/pag/presentation/570216.
