Faculty 
Prof. Christopher Liu OBE – Chair and Moderator – Consultant Ophthalmologist (Brighton, UK)
Dr Steve Arshinoff – Speaker - Consultant Ophthalmologist (Toronto, Canada)
Dr Björn Johansson – Speaker - Consultant Ophthalmologist (Linköping, Sweden)
Mr Andy Cassels-Brown – Speaker - Consultant Ophthalmologist (NHS Orkney, Scotland)

COVID-19 presents healthcare providers with a new set of challenges. The need for efficiency, with reduced resources, and the requirement for minimisation of a patient’s time on hospital premises raises the prospect of Immediately Sequential Bilateral Cataract Surgery (ISBCS) as a possible solution. Bausch + Lomb UK drew together a faculty of international experts to provide practical considerations for those considering taking their next steps with ISBCS. 

Highlights from the webinar are summarised below and full access to the webinar recording can be viewed above.

At the start of the webinar, a poll was sent to all attendees:
Q: I have a good understanding of all issues surrounding Immediately Sequential Bilateral Cataract Surgery?
A: 27.4% answered Yes whilst 72.6% answered No.

A proponent of safe, informed ISBCS, Professor Liu opened the webinar by sharing some practical considerations for those looking to commence ISBCS and outlined both the rationale for the approach and some important prerequisites. 

Discussing the comparisons between ISBCS and Delayed Sequential Bilateral Cataract Surgery (DSBCS), Dr Steve Arshinoff shared his wealth of experience of performing routine bilateral cataract surgery in Canada since 1996.  He explained that it is important to embark upon ISBCS only once every step of the procedure has been perfected. In addition, several publications on ISBCS were shared comparing complication rates in patients with ISBCS and DSBCS. Dr Arshinoff also provided information on the International Society of Bilateral Cataract Surgeons (iSBCS) which provides resources for colleagues looking to embark on this type of surgery including a useful document on the General Principles for Excellence in ISBCS. 

Dr Björn Johansson has been performing ISBCS in Sweden since 1999 and authored publications on the subject in the early 2000s. During the webinar he shared his experiences of transitioning to ISBCS and key learnings. Despite having different reimbursement models in each region, Sweden have been successful in integrating ISBCS with an increase in procedures from 2010 to 2017.

Reporting on his early experiences of ISBCS in rural Scotland, Mr Cassels-Brown shared the advantages of ISBCS for, not only patients and hospitals, but also the wider community and our planet. Recent audit results were presented demonstrating ISBCS has the potential to improve productivity, costs, the carbon footprint and the COVID-19 risk.

The faculty discussed the funding model for ISBCS and the controversial money vs. ethics debate. It was highlighted that it is appropriate only to lobby jurisdictions to fund surgery equally and fairly. Patients should be given informed choice and government bodies and public health providers should adapt to offer ISBCS. 

The webinar facilitated a live Q+A session where the faculty provided practical considerations with discussions around whether the left or right eye should be operated on first and if each speaker would personally have ISBCS (all answered “Yes”).

At the end of the webinar the same poll was shared to all attendees
Q: I have a good understanding of all issues surrounding Immediately Sequential Bilateral Cataract Surgery?
A: 94% answered Yes whilst 6% answered No

In summary, ISBCS is a valid and highly efficient method of cataract surgery provided that quality and infection control are assured, monitored and maintained. 

For further information on the webinar, please contact acuity@bausch.com.