Immediate Sequential Bilateral Cataract Surgery (ISBCS) is a controversial topic in ophthalmology that has its supporters and opponents. Below I summarize the common opinions and views:

Agreeable (Strengths):

1. Reducing the number of visits and patient comfort:
· The patient receives anesthesia or sedation only once.
· Improvement of vision in both eyes at the same time eliminates the need for temporary glasses between two surgeries.
· Less travel and time is required for elderly patients or people with limited access to medical centers.
2. Faster return to normal life:
· The recovery period is focused and the patient returns to daily activities sooner.
3. Reduction of overall costs:
· Reduction of hospital costs, transportation and post-operative care.
4. Advances in technology and safety:
· With modern techniques (microincision, advanced phacoemulsification) and strict disinfection protocols, the risk of endophthalmitis (intraocular infection) is greatly reduced.
· Use of separate sterile instruments for each eye or complete sterilization between two procedures.

Opponents (weaknesses and concerns):

1. Risk of bilateral endophthalmitis:
· Although very rare, if infection occurs in both eyes, it will have severe visual consequences. This is the biggest concern of the opposition. 2. Unexpected Refractive Errors:
· If an intraocular lens (IOL) miscalculation occurs in one eye, both eyes are affected.
3. Possible problems in the first surgery:
· If a complication occurs in the first eye (for example, posterior capsule rupture), the surgeon can postpone the second eye surgery plan or change the technique. This is not possible in simultaneous surgery.
4. Visual mismatch (Aniseikonia):
· In rare cases, there may be a significant difference in the image quality of the two eyes after the operation, which requires adjustment.

Opinions of reputable organizations and performance conditions:

· The International Society of Cataract Surgery (ISRS) and the European Society of Cataract and Refractive Surgeons (ESCRS) have established strict protocols for ISBCS, including:
· Surgery performed by a highly experienced surgeon.
· Use of two completely separate sets of instruments and solutions for each eye.
· Separate operating room or complete sterilization between procedures.
· Screening Accurate patients (for example, the absence of infection risk factors).
· Fully informed patient consent.

Summary and current opinion of the ophthalmology community:

· ISBCS has been accepted as a safe and reasonable option for selected patients, but surgery with an interval (usually a few weeks between two procedures) still remains the gold standard.
· It is usually reserved for healthy patients with relatively symmetrical cataracts and no other complicating eye disease.
· May be a better option for high anesthetic risk patients, children with congenital cataracts, or those for whom travel is difficult.

Conclusion: The decision to perform simultaneous surgery should be made after a complete risk/benefit assessment, careful patient selection, strict safety protocols, and a clear discussion with the patient. Finally, the preference of the surgeon and the condition of the patient are decisive.

If you or someone close to you is considering this option, a careful consultation with an experienced cataract surgeon who can explain both procedures to you is essential.