Surgical technique
All surgeries in this study will be performed using the standard phacoemulsification technique. This is the routine method used in almost all cataract operations in the NHS and private hospitals. It involves using gentle ultrasound energy to soften and remove the cloudy lens through a very small incision, after which the new lens implant is inserted.
The second eye surgery will take place either on the same day as the first operation (called Immediate Sequential Bilateral Cataract Surgery, or ISBCS) or within about a month of the first operation (called Delayed Sequential Bilateral Cataract Surgery, or DSBCS).
Both options are used and, in the NHS, and the choice will depend on what you based on your understanding of the benefits and risks.
ISBCS (Immediate Sequential Bilateral Cataract Surgery) | DSBCS (Delayed Sequential Bilateral Cataract Surgery) | |
Definition | Both eyes are operated on during the same surgical session. | Each eye is operated on separate days, usually weeks apart. |
Benefits | Only one pre-operative pathway and one recovery period. Both eyes achieve improved vision at the same time, avoiding temporary visual imbalance. Often more convenient for patients who travel long distances or rely on carers/family support. | The outcome of the first eye can be reviewed before the second surgery, allowing small adjustments if required. Any short-term visual or comfort issues with the first eye can be addressed before the second operation. |
Considerations | There is an extremely small theoretical risk of infection affecting both eyes (estimated approximately 1 in 200,000). To minimise this risk, each eye is treated as a completely separate sterile procedure, with new instruments and surgical materials. Lens power cannot be adjusted for the second eye based on the first eye’s outcome. | Requires two separate surgical visits and two recovery periods. Between surgeries, the eyes may focus differently, causing temporary visual imbalance. Adaptation to the new lenses may take longer while waiting for the second eye surgery. |
Your surgeon will explain both options clearly, answer any questions, and guide you to the best approach for you. Please refer also to the Moorfields NHS cataract information pack. Whatever option you choose, all surgery in this study will be carried out by an experienced Consultant Ophthalmic Surgeon, using the same high-quality surgical techniques and safety standards applied in all routine cataract operations at Moorfields Eye Hospital.
Multifocal intraocular lens in bilateral cataract surgery is the G-PERFECT study. The study is sponsored by Moorfields Eye Hospital NHS Foundation Trust and funded by Alcon Eye Care UK Limited.
