Cataract surgery on two eyes at the same time yields benefits for the patient, finances and the environment | Healthy

With 180,000 operations per year – and therefore almost 500 per day – cataract surgery is the most commonly performed procedure in the Netherlands. Cataracts are an eye condition in which the lens of the eye becomes cloudy with age, causing vision to deteriorate. Until now, the treatment was divided into two parts: first you will be operated on one eye, two weeks later on the second. Performing these two operations in one go does not lead to more complications and the improvement in vision is the same as with the previous operation, Professor Rudy Nuijts and his co-researchers conclude after researching 865 patients.

The well-known two weeks between the two eye operations are traditionally kept to prevent inflammation in both eyes at the same time. A complication due to an infection has become rare, says Nuijts. This occurs in 1 in 15,000 eyes. We now leave antibiotics in the eye, which reduces the chance.”

To keep that chance small, both eyes are treated as two separate operations, says Lindsay Spekreijse, PhD student on this research that is funded by ZonMw, a funding organization for innovation and research in healthcare. “We do one eye first and if that goes well, the second. That means we switch all instruments, fluids and medication after the first eye. For example, we use instruments of different sterilization moments. That minimizes the risk of infection.

The benefits of this new technique for the patient are great, says Nuijts. After surgery, patients need to drip their eyes several times a day. Two operations at different times thus lead to overlapping drip schedules.

“Some of the patients receive home care for this. The new technology provides one clear drip schedule and less commitment to home care. The patient also experiences no difference in vision between the two eyes in the interim period. In addition, family has to take less time off for trips to the hospital, because there are fewer appointments. Normally you come for a preliminary examination, for the operation on the first eye, for follow-up checks, and the same schedule for the next eye.”

Sandra Vorstenbosch from Beek in Limburg underwent her cataract surgery 5 weeks ago. Since childhood, with -10, she sees very poorly. “When my eyes were checked at the hospital, they saw that I had cataracts. This had gone unnoticed by me, because my eyesight was already bad.

In the hospital, Vorstenbosch asked Professor Nuijts if they couldn’t do two eyes at the same time. To her surprise, she heard ‘yes’. “I thought: if only I hadn’t asked, something will go wrong and it’s your eyes after all. But it immediately turned out to have advantages. I only had to call in sick once and didn’t dread the second surgery. You look up to it anyway. Then I only had to go to the hospital once for a check-up, which saves you another trip.”

From the moment Vorstenbosch came home, she could see immediately. “A bright, colorful world has opened up to me. It takes some getting used to: I sometimes look for my glasses or contact lenses, which I had since childhood, and then realize that I no longer need them. Now I am very happy with the operation, with how quickly it went and how I was put at ease in the hospital.”

From her work – Vorstenbosch works in district nursing – she also sees the advantages of the new technology. She helps people who can’t drip themselves after cataract surgery. “It saves so many care moments. Looking at the workload and staff shortage, this is progress. And it’s more environmentally friendly.”

Nuijts and his team saw that, in the most optimal scenario, up to 27 million euros could be saved annually in social costs if this were introduced throughout the Netherlands.

The amount of CO2 emissions saved was also mapped out. A reduction of 25 percent, mainly because people had to go to and from the hospital less, sees Nuijts. Over the next two years, the team will investigate how this technique can be further implemented in the Netherlands.