Abstract
PURPOSE: To determine the patient selection and maintain standards to improve the safety of immediate sequential bilateral cataract surgery (ISBCS) in tropical regions that are hot, humid, and prone to infections. MATERIALS AND METHODS: Thirty-nine participants (78 eyes) meeting stringent inclusion criteria underwent ISBCS. The stricter criteria included absence of systemic disease, absence of ocular abnormalities, and presence of physiological cataract (not traumatic cataract, complicated cataract, pseudoexfoliation, etc.). ISBCS was performed using the phaco-chop technique with a Venturi phaco machine, bimanual irrigation/aspiration, and hydro-implantation of the intraocular lens (IOL). Intraoperative complications (posterior capsule rupture (PCR) and vitreous loss) and postoperative outcomes (corneal edema, toxic anterior segment syndrome (TASS), and endophthalmitis) were monitored. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were measured and compared pre- and postoperatively. Statistical analysis was performed, with p < 0.05 considered statistically significant. RESULTS: No intraoperative complications (PCR and vitreous loss) were observed. And no postoperative (visual-disturbing corneal edema, TASS, and endophthalmitis) cases were observed. Minimal corneal edema was confirmed with no negative impacts on visual functions. Significant improvements occurred in UCVA and BCVA (p < 0.001), respectively, alongside significant reductions in IOP (p < 0.001). CONCLUSION: Strict patient selection and maintained standards may improve the safety of ISBCS in tropical regions by preventing intraoperative PCR and vitreous loss, as well as postoperative complications such as visual-disturbing corneal edema, TASS, and endophthalmitis. This approach may also facilitate rapid rehabilitation of UCVA and BCVA, maintain corneal stability, and reduce IOP.