I cannot imagine the response from my attendings 30 years ago had I suggested considering simultaneous bilateral cataract surgery (SBCS); it probably would have ended my residency. Then, the standard was intracapsular cataract extraction; its prolonged recoveries and many complications were the norm. Today, the surgery is much improved. In this issue of the Canadian Journal of Ophthalmology, O'Brien et al. present the case for SBCS. Many complications that occurred in the past do not raise the same levels of concern today; therefore, the authors assert that we should consider SBCS when it is the easiest approach for visual recovery, and because it is more efficient for the patient, healthcare system, and physician. Indeed, as one assesses the data from O'Brien et al.1, the question may be: "Why not SBCS?" There are several reasons that may cause surgeons to hesitate before performing SBCS.
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