Same-day cataract surgery should not be the standard of care for patients with bilateral visually significant cataract.

Benefits of sequential surgery include assessment of the outcome of the first surgery to tailor the surgical technique, intraocular lens (IOL) power, and choice of IOL for the second surgery. Additionally, recovery may be prolonged from corneal edema, anterior chamber inflammation, or cystoid macular edema. Allowing the patient to maintain visual function in one eye during the recovery of the other eye can be important. Therefore, the few benefits of simultaneous surgery are greatly outweighed by risks of bilateral complications, inability to foresee refractive outcome, inability to alter IOL choice, potential loss of physician reimbursement, and possible increased legal ramifications.