Journal of Cataract and Refractive Surgery, volume 51, issue 3, pages 210-217

Surgeon Adoption of Immediate Sequential Bilateral Cataract Surgery in the United States from 2018 to 2022

Muhammad Ali 1
, 
Chen Dun 2
, 
David F Chang 3
, 
Hyeck-Soo Son 4
, 
Fasika A. Woreta 1
, 
Uri S. Soiberman 1
, 
Christina R. Prescott 5
, 
Martin A. Makary 2
, 
Divya Srikumaran 6
Show full list: 9 authors
1
 
2
 
3
 
Altos Eye Physicians, Los Altos, CA, USA | 
4
 
Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, BW, Germany | 
5
 
6
 
Wilmer Eye Institute| Wilmer Eye Institute
Publication type: Journal Article
Publication date: 2025-03-01
scimago Q1
SJR: 1.472
CiteScore: 5.6
Impact factor: 2.6
ISSN: 08863350, 18734502
Abstract
Purpose:

To assess 5-year trends in the rate of immediate sequential bilateral cataract surgery (ISBCS) and surgeon characteristics associated with performing ISBCS.

Setting:

100% Medicare Fee-For-Service beneficiaries from 2018 to 2022.

Design:

Cross-sectional study.

Methods:

ISBCS cases were identified among patients aged 65 years or older undergoing bilaterally performed cataract surgery (BPCS). Cochrane Armitage trend test was used to assess patient and surgeon characteristics over time. Multivariate logistic regression was used to evaluate surgeon characteristics associated with performing ISBCS.

Results:

Among 1 190 169 BPCS, 3954 (0.33%) were ISBCS. Quarterly ISBCS rate increased from 2.12 to 5.5 per 1000 BPCS (P < .001). Among 10 290 surgeons, 1119 (10.87%) performed ISBCS on some patients. Proportion of surgeons performing ISBCS per 1000 cataract surgeons increased from 15.63 during the first quarter of 2018 to 26.55 during the last quarter of 2022 (P < .001). Among the ISBCS surgeons, the proportion of ISBCS cases per 1000 BPCS doubled from 17.20 in 2018 to 35.50 in 2022 (P < .001). On multivariate analysis, surgeons in the highest surgical volume quartile (odds ratio [OR], 1.21; 95% CI, 1.01-1.45; Ref: lowest quartile), recent graduates (0 to 10 years: OR, 2.43; 95% CI, 1.87-3.15; Ref: ≥ 31 years), and surgeons in the West (OR, 2.408; 95% CI, 2.052-2.826; Ref: South) had higher odds of performing ISBCS.

Conclusions:

There was an increased rate of ISBCS possibly suggesting greater interest among patients and surgeons. Although the overall ISBCS rate remained low, the number of surgeons performing ISBCS increased. Higher volume surgeons, recent graduates, and those practicing in the West were more likely to perform ISBCS.

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