scholarly journals Modified manual small incision cataract surgery technique for phacoemulsification-trained surgeons

2020 ◽  
Vol 12 ◽  
pp. 251584142097737
Author(s):  
Darren S. J. Ting ◽  
Daniel Chua ◽  
Khin Oo May ◽  
Mya Aung ◽  
Ashish Kumar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Visual Outcome ◽  
Modified Technique ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Capsular Rupture ◽  
Best Corrected Visual Acuity

Purpose: To present the technique and outcomes of a modified manual small incision cataract surgery designed for the phacoemulsification surgeons who are learning to perform manual small incision cataract surgery. Methods: This was a retrospective, single-centred, comparative study. We included all the patients who underwent the modified manual small incision cataract surgery for visually significant cataract at Singapore National Eye Centre. All surgeries were performed by either a senior phaco-trained surgeon (M.A.) who had performed more than 500 manual small incision cataract surgery or a junior phaco-trained surgeon (D.C.) who had performed around 500 phacoemulsification but never performed any manual small incision cataract surgery. The main modification of this technique lies in the creation of an additional phaco-like main wound at 90° to the scleral tunnel wound, with most surgical steps performed through this additional wound. The outcomes were analysed and compared between the senior and junior surgeons. The main outcome measures were visual outcome and major intraoperative complications such as posterior capsular rupture and zonular dialysis. Results: A total of 132 cases were included; 102 (77.3%) and 30 (22.7%) cases were performed by the senior and junior surgeons, respectively. Pre-operatively, 85.6% eyes had best-corrected visual acuity of counting fingers or worse. Postoperatively, the visual outcome at 1 month was similar between the senior and junior surgeons, with 68.7% eyes achieving a best-corrected visual acuity of ⩾6/12 ( p = 0.17). No posterior capsular rupture, zonular dialysis or endophthalmitis was observed during the study period. Conclusions: This modified technique may serve as a useful transition technique for the phaco-trained surgeons to develop skills in manual small incision cataract surgery, with demonstrable good visual outcome and safety.

scholarly journals Visual Outcome of Phacoemulsification Versus Small Incision Cataract Surgery

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Narain Das ◽  
Asma Shams Shaikh ◽  
Jai Kumar ◽  
Beenish Khan ◽  
Nasir Bhatti
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Small Incision Cataract Surgery ◽  
Visual Rehabilitation ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Group I ◽  
Group Ii ◽  
Best Corrected Visual Acuity ◽  
Group 1

Purpose:  To determine visual rehabilitation of Phacoemulsification in comparison to small incision cataract surgery after implantation of rigid intraocular lens. Study Design:  Quasi Experimental Study. Place and Duration of Study:  Shaheed Mohtarma Benazir Bhutto Medical College Lyari and Sindh Government Lyari General Hospital, Karachi, from July 2018 to December 2019. Methods:  Patients with 35 – 70 years age and diagnosed with senile cataracts and visual acuity of <6/36were included. Patients having any corneal disease, intra-ocular pressure > 22 mmHg, high ametropia, any other eye disease were excluded. Patients were divided into two groups of 80 patients each. Group I underwent Phaco-emulsification and group II had Small incision cataract surgery. For data analysis, SPSS version 20.0 was used. Frequency and percentages were calculated for qualitative data and quantitative data was presented as mean and standard deviation. Results:  In a total of 160 patients operated of cataract, male to female ratio was 1:1. The range of astigmatism after 6 months in the group I was between 0.5 – 1.00 D while in the group II, it was between 0.75 – 1.75 D. Uncorrected visual acuity and best corrected visual acuity of 6/18 or better was seen in 90 and 97% group 1 while it was 85% and 95% in group II patients respectively at sixth month. Conclusion:  No significant difference was seen in uncorrected and best corrected visual acuity between the two groups. Time of surgery was lesser group 2 and Astigmatism was lesser in group 1. Key Words:  Phaco-emulsification, Small Incision Cataract Surgery, Visual Rehabilitation.

scholarly journals Visual Outcome after Manual Small Incision Cataract Surgery for Phacolytic Glaucoma

2020 ◽  
pp. 54-59
Author(s):  
Shams Mohammad Noman ◽  
M. A. Karim
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Visual Outcome ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Phacolytic Glaucoma ◽  
The Mean ◽  
Expulsive Hemorrhage

Aim: To evaluate the visual outcome after manual small incision cataract surgery (MSICS) as a treatment of phacolytic glaucoma. Methods: The study included 43 patients with phacolytic glaucoma treated by manual small incision cataract surgery with intraocular lens implantation. Preoperative and postoperative visual acuity and intraocular pressure have been recorded and compared at the end of six weeks after surgery. Results: The mean preoperative intraocular pressure was 36.23 (± 10.86) mm of Hg. There were no significant intraoperative complications such as posterior capsular tear or expulsive hemorrhage. Post operative mean intraocular pressure (IOP) was 12.58 (± 3.45) mm Hg. Pre operative visual acuity in all the affected eyes were perception of light with projection of rays in all quadrant. Postoperative best corrected visual acuity was 6/6-6/18 in 27 patients (62.80%), 6/24- 6/36 in 10 patients (23.25%) and ≤ 6/60 in 6 patients (13.95%). Conclusion: Manual small incision cataract surgery is a safe and effective method of treatment for phacolytic glaucoma and the visual outcome and IOP reduction is satisfactory.

scholarly journals Improving the Outcomes of Modified Manual Small Incision Cataract Surgery Using Clinical Audit

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Muhammad Ifraheem Khan ◽  
Saba Ali Arif ◽  
Muhammad Raja ◽  
Sheikh Ijaz ◽  
Muhammad Saeed Khan
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Clinical Audit ◽  
Cataract Extraction ◽  
University Hospital ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Good Technique ◽  
Capsular Rupture

Purpose:  To use clinical audit in improving the outcomes of manual small incision cataract surgery technique Study Design:  Clinical audit. Place and Duration:  Layton Rehmatullah Benevolent Trust Eye hospital Karachi, from September 2019 to December 2019. Methods:  Two hundred patients who had undergone Manual Small Incision Cataract surgery were selected. Cases with traumatic cataract, weak zonules, pseudoexfoliation, and more than 1 diopter difference in keratometric readings, corneal and retinal pathologies were excluded. Surgical complications and visual outcomes were recorded on the 7th postoperative day. Refractive data was recorded from subjective refraction. Data was analyzed by University Hospital Bristol formula. Standards were set using international literature. Deficiencies were noted and technique was modified to improve the outcome. The audit was repeated after 2 months to see whether modifications had improved the outcome. Results:  In the first audit, posterior capsular rupture rate was 1%, corrected visual acuity of 6/12 or better was achieved in 85.36% and surgically induced cylinder of less than 2 DC was achieved in 75.60% of the patients. In the second audit all standards were achieved. Posterior capsular rupture did not occur. Corrected visual acuity of 6/12 or better was achieved in 90.50% and induced cylinder of less than 2 DC was achieved in 87.05% of the patients. Conclusion:  Clinical audit of the surgical procedures is a good technique in improving the outcomes of manual small incision cataract surgery. Key Words:  Cataract extraction, clinical audit, posterior capsular rupture, astigmatism, visual acuity.

scholarly journals Cataract surgery in camp patients: a study on visual outcomes

1970 ◽  
Vol 3 (2) ◽  
pp. 159-164
Author(s):  
SG Pai ◽  
SJ Kamath ◽  
V Kedia ◽  
K Shruthi ◽  
A Pai
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Evaluation Team ◽  
Visual Outcomes ◽  
Corrected Visual Acuity ◽  
Operative Complications ◽  
Best Corrected Visual Acuity

Aim: To assess the complications and visual outcomes associated with cataract surgery in camp patients operated at a tertiary centre. Materials and methods: In a retrospective study, 206 outreach camp patients had undergone cataract surgeries with posterior chamber intraocular lens implantation under peribulbar anesthesia over a period of 6 months. Post-operative complications on Day 1 were graded as per Oxford Cataract Treatment and Evaluation Team (OCTET) definitions. One month postoperative complications, best corrected visual acuity and refractive errors were assessed. Results: 206 eyes underwent cataract extraction with PCIOL implantation. Small incision cataract surgery (SICS) was the commonest method (78.6%) used. The most common first post-operative day complication was mild iridocyclitis (26.2%). The complications were based on OCTET definitions, and showed that 33 % had Grade I and 3.4 % had Grade II complications. The major post-operative complication after 4 weeks of surgery was posterior capsular opacity. 89.8 % of the eyes had a 4 week-post-operative best corrected visual acuity of e” 6/24. The commonest refractive error was myopia with against the rule astigmatism, seen in 86 out of 150 cases. Conclusion: High quality cataract surgery with a low rate of intra-operative complications and good visual outcome can be attained in camp patients operated in the base hospitals, thus justifying more similar screening camps to clear the vast cataract backlog. Key words: cataract surgery, eye camp, visual outcomes DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5270 Nepal J Ophthalmol 2011; 3(2): 159-164

scholarly journals A novel nucleus extraction technique using a vectis in sutureless, manual, small-incision cataract surgery

2014 ◽  
Vol 6 (2) ◽  
pp. 140-144
Author(s):  
Yuan Zeng ◽  
Jiang-wen Deng ◽  
Jian-hua Gao
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Operating Time ◽  
Corneal Edema ◽  
Extraction Technique ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Posterior Capsule Rupture ◽  
Best Corrected Visual Acuity

Introduction: In manual, tunnel-incision cataract surgery, nucleus extraction has remained a crucial issue and a challenge. It is also the period when serious complications easily occur, especially for beginners and when the nucleus is large and dense.  Objectives: To report a modified vectis technique for nucleus extraction in sutureless, manual, small-incision cataract surgery (MSICS) to improve the safety and ease of performance.Materials and methods: A novel nucleus extraction technique using a vectis in MSICS is presented. After capsulorhexis and hydrodissection, the nucleus is moved into the anterior chamber and extracted by pulling with a Sinskey hook and pressuring on the scleral bed near the posterior wound margin with an irrigating vectis. Main outcome measures: The operating time for the whole surgery and nucleus extraction, best corrected visual acuity postoperatively and complications during and after operation were recorded. Results: In a series of 1,180 eyes, the operating time for the whole surgery and nucleus extraction were 8±3.4 minutes and 5.1±4.6 seconds respectively. Among all the eyes, 88.98 % achieved a best-corrected visual acuity of 5/10 or better two months postoperatively. The complications were posterior capsule rupture (4 eyes, 0.34 %) and transient corneal edema (12 eyes, 1.02 %). Neither vitreous loss nor dislocation of the nucleus into the vitreous was noted in the whole series of the surgery. Conclusions: We found that the “scleral bed” vectis technique for nucleus extraction improved the ease of performance, safety of MSICS, and did not require expensive instrumentation.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11708Nepal J Ophthalmol 2014; 6 (12): 140-144 

scholarly journals Study of Intraoperative Complications in Small Incision Cataract Surgery, its Management and Visual Outcome

2016 ◽  
Vol 3 (1) ◽  
pp. 52 ◽  
Author(s):  
Mrunal Suresh Patil ◽  
Dhiraj Namdeo Balwir ◽  
Sonal Dua
Keyword(s):  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Visual Outcome ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Study Results ◽  
The Common ◽  
Iris Prolapse

Aims: To study the intraoperative complications in small incision cataract surgery and its management and to study the visual outcome following the management of intraoperative complications. Material and Methods: A total of 250 cases studied from who underwent SICS. Intraoperative complications were studied and managed. Visual outcome following these complications were studied by noting the best corrected visual acuity after day 1, 1<sup>st</sup> week, 3<sup>rd</sup> week, 6<sup>th</sup> week following surgery. Results: The total intraoperative complications were seen in 22 (8.8%) patients. Posterior capsule rent was seen in 6 eyes (2.4%). Iris prolapse in 5 eyes (2%). Descemet detachment was seen in 3 eyes (1.2%). Premature entry was seen in 3 eyes (1.2%). Capsulorrhexis extension was seen in 2 eyes (0.8%). Zonular dialysis was seen in 2 eyes (0.8%). Superior iridodialysis was seen in only one eye (0.4%). Out of 250 cases, 246 came for follow up till 6th week. 214 (85.6%) patients had post operative BCVA 6/6 at the end of 6<sup>th</sup> week, 25(10%) patients had 6/9, 5 patients (2%) had 6/12-6/18 and remaining 2 patients (0.8%) had 6/24-6/36 BCVA. Conclusion: The study results shows that in high quality cataract surgery (91.2% without intraoperative complications) 99% BCVA 6/18 or better can be attained. In our study incidence of intraoperative complications was 8.8% in which posterior capsular rent and iris prolapse were the common intraoperative complications.

scholarly journals Visual outcome and complications of manual small incision cataract Surgery (MSICS) in a peripheral CMH

2015 ◽  
Vol 10 (1) ◽  
pp. 14-18
Author(s):  
Md Abdullah Al Masum ◽  
Md Kamrul Hasan Khan ◽  
M Anwar Hossain
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Cost Effective ◽  
Armed Forces ◽  
World Health ◽  
Military Hospital ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Cataract Patients

Introduction: Manual small incision cataract surgery (MSICS) is a cost-effective alternative to phacoemulsification cataract surgery for developing countries. This prospective study was carried out in Combined Military Hospital (CMH), Chittagong from October 2009 to March 2011 on 75 cataract patients who were operated by MSICS technique. Objectives: Aim of this study was to assess the visual outcome and complications of MSICS in a peripheral CMH. Methods: Seventy five cataract patients were operated by MSICS technique. All surgical procedures were performed by the principal author. Major per-operative and postoperative complications were documented. Visual outcome was assessed by Snellen’s visual acuity test 06 weeks after operation. Results: Uncorrected visual acuity (UCVA) was 6/6 – 6/18 in 57 (76.0%) patients, < 6/18 – 6/60 in 15 (20%) and < 6/60 in 03 (4.0%) patients. Best corrected visual acuity (BCVA) was 6/6-6/18 in 65 (86.7%) patients, < 6/18-6/60 in 07 (9.3%) and < 6/60 in 03(4.0%) patients. Visual outcome was good in 86.7% of patients according to World Health Orgnization (WHO) criteria and was not far away from the WHO expected outcome. Posterior capsule rupture was the most significant per-operative complication which was found in 7(9.3%) cases and surgically induced astigmatism was main postoperative complication that affected visual outcome. Mean postoperative astigmatism (against-the rule) was - 1.25DC. 14 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Conclusion: MSICS is a safe and cost-effective technique of extra-capsular cataract extraction where surgical skill and experience of the surgeon plays a significant role in the result. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22895 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

scholarly journals Hospital-based community cataract surgery: comparison of visual outcomes between conventional extra-capsular cataract extraction and small incision cataract surgery

1970 ◽  
Vol 1 (2) ◽  
pp. 118-122 ◽  
Author(s):  
P Karki ◽  
JK Shrestha ◽  
JB Shrestha
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Cataract Extraction ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Mean Values ◽  
Visual Outcomes ◽  
Small Incision ◽  
Statistical Program

Introduction: The small-incision cataract surgery is gaining popularity among the ophthalmic surgeons. Objective: To compare the visual outcome of conventional extra-capsular cataract extraction (ECCE) and small-incision cataract surgery (SICS) in a hospital based community cataract program. Materials and methods: A prospective interventional study without randomization was carried out including the patients undergoing cataract surgery by either conventional ECCE or manual SICS. They were followed up for 6 weeks postoperatively. The visual outcomes were compared between the two groups. Statistics: The statistical program Epi-Info version 2000 was used to analyze the data. Mean values with standard deviations, 95% CI and p value were calculated. The p value of <0.05 was considered significant. Results: Of 85 patients, 44 (M: F=10:34) underwent ECCE and 41 (M: F=15:26) SICS (RR= 0.71, 95% CI=0.42-1.2, p value=0.16). Unaided visual acuity on the 1st postoperative day in the ECCE group was e"6/ 18 in 22.7%,<6/18-6/60 in 63.6 %,< 6/60 in 13.7%, whereas in the SICS group, the same was e"6/18 in 70.7%,<6/18-6/60 in 22 %,< 6/60 in 7.3% (95% CI = 0.23 - 0.48, p=0.001). Best corrected visual acuity on the 6th week follow-up in the ECCE group was e"6/18 in 79.5%,<6/18-6/60 in 18.2 %,< 6/60 in 2.3% and in the SICS group the same was 6/18 in 90.5% and <6/18-6/60 in 4.9% (95% CI=0.44 - 0.73; p=0.0012). Conclusion: Both ECCE and SICS are good procedures for hospital based community cataract surgery but within the 6 weeks postoperative period SICS gives better visual outcome. Remarkably higher number of female patients can be provided service in a hospital based community cataract programme as compared to males. Keywords: cataract; small incision; extra-capsular DOI: 10.3126/nepjoph.v1i2.3686 Nep J Oph 2009;1(2):118-122

Sign in / Sign up

Export Citation Format

Share Document