This study developed a novel questionnaire to investigate the prevalence of, factors for, and surgeons’ attitudes toward immediate sequential bilateral ICL surgery(ISBICLS), and distributed it to 792 ophthalmologists in Mainland China.

ISBICLS has not been widely accepted as a routine procedure in Mainland China. The experience and skill of surgeons mainly influences whether they performed ISBICLS. The broad range of identified factors provides basis for further evidence-based research.

Endophthalmitis risk and vault predictability should both be predominant factors in determining the appropriate workflow of ICL surgery.

Our findings may inform the future revision of expert consensus of ICL surgery, including the standardized protocols to prevent endophthalmitis, the appropriate time interval of two eye surgery, and requisitions for surgeon skills.