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Acceptability of immediate sequential bilateral cataract surgery (ISBCS) in a public health care setting before and after COVID-19: a prospective patient questionnaire survey
  1. Vishal Shah1,
  2. Khayam Naderi1,2,
  3. Laura Maubon1,
  4. Ashmal Jameel1,
  5. Darshak S Patel1,
  6. Jack Gormley1,
  7. Sanjeev Heemraz1,
  8. Elodie Azan1,
  9. Seema Verma1,
  10. Sancy Low1,
  11. David O'Brart1,2
  1. 1Department of Ophthalmology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
  2. 2King's College London, London, UK
  1. Correspondence to David O'Brart; david.obrart{at}


Objective To ascertain patient acceptance of immediate sequential bilateral cataract surgery (ISBCS) in the National Health Service (NHS).

Methods A survey was devised using a 5-point Likert scale for questions related to ISBCS, which patients undertook during their cataract outpatient appointment pre-COVID-19 lockdown and by telephone during the lockdown.

Results Questionnaires were completed for 267 patients. Most respondents were aged over 71 (51%) and were female individuals (60%). Forty-five per cent agreed/strongly agreed with opting for ISBCS. A positive correlation was identified between opting for ISBCS and convenience to the patient (r=0.76, p<0.01) and family/carer/partner (r=0.71, p<0.01) and wanting to limit numbers of hospital visits (r=0.57, p<0.01). Fifty per cent agreed/strongly agreed that they were worried about the risk of simultaneous bilateral ocular complications, with this correlating with being less likely to opt for ISBCS (r=−0.49, p<0.01) and being scared of ISBCS (r=0.67, p<0.01). During COVID-19 lockdown, patients were less likely to want to minimise the time taken off work (p<0.05) and less intolerant of a prolonged hospital visit (p<0.05). Only 23% of respondents agreed/strongly agreed that they had familiarity with ISBCS.

Conclusions ISBCS was acceptable to 45% of our sampled population, suggesting limited routine implementation in the NHS is possible. Convenience and reduction in hospital visits appeared to contribute to this acceptance. Half of the patients expressed concern regarding bilateral complications and such concerns need addressing. Some attitudes did appear to change during the COVID-19 lockdown period. The familiarity of the concept of ISBCS is low suggesting the need for patient education.

  • treatment surgery
  • vision
  • public health

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  • Contributors VS, DO’B, KN and SL conceptualised project. VS, KN, LM, AJ, DP, JG, SH, EA, SV and SL contributed to data collection. VS performed data analysis and produced first draft of manuscript. DO’B revised several iterations. Final manuscript reviewed and approved by all coauthors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests DO’B holds non-commercial research grants with Rayner Ltd and Avedro. He has undertaken consultancy work for Avedro, Sparca and Alcon in the past 12 months. He holds stock in Sparca.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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