First Postoperative Day Visual Outcome Following 6 mm Manual Small Incision Cataract Surgery Using Intratunnel Phacofracture Technique

2014 ◽  
Vol 07 (01) ◽  
pp. 26 ◽  
Author(s):  
Sudhir Singh ◽  

Object:To study first postoperative day visual outcome following 6 mm manual small incision cataract surgery (MSICS) using intratunnel phacofracture technique.Design:Retrospective design.Setting:Tertiary eye care centre.Participants:A total of 216 patients who underwent MSICS performed by a single surgeon at the JW Global Hospital & Research Centre, Mount Abu, India from April 2012 to March 2013. Cataract patients with any other ocular comorbidity were not included. One hundred and thirty-six cataract patients (72 male/64 female) with a mean age of 59.75 years (range 40–80 years) were included in the study. All surgeries were performed by a single surgeon using the 6 mm MSICS intratunnel phacofracture technique.Outcome measures:The first postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and rates and types of complications were recorded.Results:A total of 136 surgeries were performed using the 6 mm MSICS intratunnel phacofracture technique. All the surgeries were performed by a single experienced surgeon. The mean UCVA and mean BCVA at first postoperative day were 0.367 (Snellen equivalent 20/46) and 0.226 (Snellen equivalent 20/33) log MAR units, respectively. No serious peri- and postoperative complications were encountered.Conclusions:The 6 mm MSICS is a safe, fast, and low-cost cataract extraction technique. It is an effective alternate to costly phacoemulsification.

2015 ◽  
Vol 10 (1) ◽  
pp. 14-18
Author(s):  
Md Abdullah Al Masum ◽  
Md Kamrul Hasan Khan ◽  
M Anwar Hossain

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


1970 ◽  
Vol 1 (2) ◽  
pp. 118-122 ◽  
Author(s):  
P Karki ◽  
JK Shrestha ◽  
JB Shrestha

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


2019 ◽  
Vol 5 (2) ◽  
pp. 185-190
Author(s):  
Shamima Sultana ◽  
AQM Omar Sharif ◽  
Nazneen Begum ◽  
Salma Parveen ◽  
Wahida Begum ◽  
...  

Background: Cataract surgery is very important for the correction of visual acuity among the patients. Objective: The purpose of the present study was to assess the uncorrected visual acuity in small incision cataract surgery (SICS) with PCIOL than conventional method of ECCE with PCIOL implantation. Methodology: This cross-sectional study was conducted at National Institute of Ophthalmology, Dhaka, Bangladesh from January 1999 to December 2000 for a period of two (02) years. Patients with senile cataract were selected for study. A comparative study of changes in postoperative visual outcome and refractive status during post-operative follow up period up to 2 months were observed and documented between two groups of patients, one with suture less nonphaco SICS with PCIOL another with conventional ECCE with PCIOL. All the cataract surgery were done by the same surgeon, and in same place. All the patients were examined carefully both pre and post-operatively. For the purpose of recording, a proforma was made that includes particulars of the patient, complete history, general examination, ocular examination, relevant investigations, operation note, perioperative complications, post-operative follow-up, pre and post-operative visual acuity with keratometric reading. Result: A total of 60 eyes of cataract patients were included in the study of which 30 eyes of cataract patients were randomly selected for suture less nonphaco SICS with PCIOL and 30 eyes of cataract patients were for conventional ECCE with PCIOL.Mean age distribution (58.83±5.55 and 58.77±6.56) was similar in both groups. The unaided vision in both SICS & ECCE group at different postoperative intervals was reported. At day7 and month 1 postoperatively the result appears highly significant between the two groups. At day 1 and month 2 also shows the significant result between the 2 groups. The best corrected visual acuity in SICS and ECCE group at different postoperative intervals was measured. At day 7 and month 1 postoperatively the result appears highly significant between the two groups. At day 1 and month 2 also shows the significant result between the 2 groups.In SICS group out of 30 patients, 7(23.3%) cases acquired unaided vision 6/9 at day 1, 10(33.3%) patients at day 7,14(46.6%)patients at month 1 and 15(49.9%) patients at month 2. On the other hand in ECCE group no patient was found with vision ≥6/9 at day 1 and only one patient with vision ≥6/9 at day 7.At month 1 there were 5(16.6%) patients, and at month 2 there were 9(29.9%)patients with vision ≥6/9. Nearly 50.0% patients of SICS group achieve unaided vision of ≥6/9 within the follow up period of 02 months. Conclusion: In conclusion Uncorrected visual acuity in SICS cases were better than that of ECCE cases with sutures. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 185-190


2021 ◽  
Vol 3 (6) ◽  
pp. 101-104
Author(s):  
P. A. A. S. Surya ◽  
N. N. Sunariasih

Cataracts are the second most common cause of blindness in the world at 33%. The incidence of cataracts is 0.1% of the total population, so the number of new cataract cases in Indonesia is estimated at 250,000 per year. This study aims to compare the visual acuity of post cataract surgery patients with Small Incision Cataract Surgery and Phacoemulsification techniques at Sanjiwani Hospital, Gianyar. This study was a retrospective cohort at Ophthalmologist’s Outpatient Departement of Sanjiwani Hospital, Gianyar, Bali. The sample of this study was 60 patients with 84 eyes with senile cataract. The surgical techniques performed were Small Incision Cataract Surgery (53.6%) and Phacoemulsification (46.4%). After that, an Uncorrected Visual Acuity (UCVA) examination was carried out on day 1 and day 42. The result were cataract patients at Sanjiwani Hospital, Gianyar aged 60-65 years who were male. Comparison of visual acuity after Small Incision Cataract Surgery and Phacoemulsification had the same results. On day 1 and day 42, there was no different uncorrected visual acuity result between Small Incision Cataract Surgery and Phacoemulsification statistically.


2019 ◽  
Vol 26 (08) ◽  
pp. 1365-1369 ◽  
Author(s):  
Khawaja Abdul Hamid ◽  
Shaista Habibullah

Cataract extraction is one of the commonest surgical procedures in Ophthalmology globally. Extracapsular cataract extraction ECCE), through a small incision (SICS), with insertion of an intraocular lens has been the most widely used method from 1990s until recently. Technological advances have led to the increasing use of phacoemulsification (PE) to emulsify and remove the lens. The technique requires a smaller incision, but requires substantial capital investment in theatre equipment. In this we compared the visual outcomes of patients undergoing both surgical techniques at a public sector hospital in Mirpur. Study Design: Single-center retrospective cohort study. Setting: Department of Ophthalmology, Divisional Headquarters Hospital, New Mirpur, AJK. Period: Cataract surgery cases from January 2018 to February 2019. Materials and Methods: 196 patients with age related cataract were included in the SICS group and 115 in the phacoemulsification group. The main comparative outcome was uncorrected visual acuity 4 weeks after surgery. Results: In this study, it was found that the primary post-operative visual outcome for small incision cataract surgery and phacoemulsification was comparable in terms of uncorrected visual acuity. No statistically significant difference was found in the proportions of SICS and phacoemulsification groups when compared for UCVA of 6/9 or better, 6/60 or better and 6/60 and worse.


1970 ◽  
Vol 4 (1) ◽  
pp. 54-58 ◽  
Author(s):  
VK Malik ◽  
S Kumar ◽  
R Kamboj ◽  
C Jain ◽  
K Jain ◽  
...  

Introduction: Now-a-days, all techniques of cataract extraction are meant for giving the best uncorrected visual acuity and early post-operative rehabilitation. Purpose: To compare astigmatism induced by the superior and temporal section in manual small incision cataract surgery (SICS) in the Indian population. Materials and methods: One hundred and ten eyes were taken. Eyes having a steeper vertical keratometry reading were assigned to the superior SICS group whereas eyes with a steeper horizontal keratometry reading were assigned to the temporal SICS group. Eyes with no astigmatism were randomly assigned to either of the two groups. Both the groups had 54 eyes each. Eyes in Group 1 underwent manual SICS with a superior tunnel and eyes in Group 2 underwent manual SICS with a temporal tunnel. The patients were examined on postoperative Day1, 1 week, 45 days, and 3 months. Uncorrected and best-corrected visual acuity was recorded, slit-lamp examination, auto-refracto-meter and keratometry examinations were done. Statistics: All calculations were performed using surgically-induced astigmatism (SIA) Calculator version 1.0, a free software program. Results: In Group 2, only 35 eyes out of 54 completed the follow-up of 90 days. The mean SIA in Group1 was found to be 1.45 ± 0.7387 and in Group 2 it was 0.75± 0.4067. The z score applied was found to be 5.7143. This value was more than the standard value, i.e.2.58. The p value accordingly was < 0.001, which is highly significant. The SIA induced by the superior incision was 48.28 % more than by the temporal incision. Conclusion: SICS with the temporal approach provides a better stabilization of the refraction with a significantly less SIA than superior approach. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5851 NEPJOPH 2012; 4(1): 54-58


2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.


1970 ◽  
Vol 1 (1) ◽  
pp. 13-19 ◽  
Author(s):  
A Gurung ◽  
DB Karki ◽  
S Shrestha ◽  
AP Rijal

Background: An effective method for cataract surgery should be identified to combat cataract blindness. Aim: To study the surgical outcome of conventional extracapsular cataract extraction versus manual small-incision cataract surgery. Materials and methods: A randomized clinical trial was carried out including one hundred eyes (88 patients) which were divided into two groups using systematic randomization: groups of conventional extracapsular cataract extraction with posterior chamber intraocular lens (ECCE with PCIOL) implantation and manual small-incision cataract surgery (MSICS). The postoperative parameters/variables studied were the unaided and best-corrected visual acuity and astigmatism. Statistics: Epi info 2000 version statistical software was used for data analysis and calculation of relative risk, 95% CI and p value. The p value of less than 0.05 was considered as significant. Results: In the immediate postoperative period, unaided visual acuity of =/> 6/18 was achieved in 24 subjects in MSICS group versus 7 in ECCE with PCIOL group (RR=2.05, 95% CI=1.44 - 2.94, p = 0.0002), whereas the same at 6 - 8 weeks postoperatively was found in 28 and 22 subjects in those groups respectively (RR=1.27, 95% CI=0.86-1.89, p=0.23). The astigmatism of =/> 2 at 6 - 8 weeks was found in 35 and 17 subjects from the conventional and MSICS groups respectively ( R=2.28, 95% CI = 1.39-3.73, p=0.0002). Conclusion: Both MSICS and conventional ECCE with PCIOL are safe and effective techniques for treatment of cataract patients. A more rapid recovery of good vision can be achieved with MSICS than with conventional ECCE with PCIOL in the immediate postoperative period. Key words: ECCE; MSICS; visual acuity; astigmatism DOI: 10.3126/nepjoph.v1i1.3668 Nep J Oph 2009;1(1):13-19


Author(s):  
Hazra Soumyadeep ◽  
Saha Tapes Kanti

Background: In developing countries, manual small incision cataract surgery is a better alternative and less expensive in comparison to phacoemulsification and thus the incision is an important factor causing high rates of postoperative astigmatism resulting into poor visual outcome. Thus, modifications to the site of the incision is needed to reduce the pre-existing astigmatism and also to prevent postoperative astigmatism. Modification to superotemporal incision relieves pre-existing astigmatism majorly due to its characteristic of neutralizing against-the-rule astigmatism, which is more prevalent among elderly population and thus improves the visual outcome. Aims: To study the incidence, amount and type of surgically induced astigmatism in superior and superotemporal scleral incision in manual SICS. Methodology: It is a randomized, comparative clinical study done on 100 patients attending the OPD of Ophthalmology at a tertiary care hospital, with senile cataract within a period of one year and underwent manual SICS. 50 of them chosen randomly for superior incision and rest 50 with superotemporal incision. MSICS with PCIOL implantation were performed through unsutured 6.5 mm scleral incision in all. Patients were examined post-operatively on 1st day, 7th day, 2nd week and 4th week and astigmatism was evaluated and compared in both groups. Results: It is seen that on postoperative follow up on 4th week, 77.78% of the patients with ATR astigmatism who underwent superior incision had increased astigmatism whereas, only 13.63% of the patients with ATR astigmatism who underwent supero-temporal incision, had increased astigmatism but 81.82% had decreased ATR astigmatism. However, 77.78% of the patients with preoperative WTR astigmatism who underwent supero-temporal incision, had increased astigmatism, whereas 44.45% of the patients with WTR astigmatism preoperatively, had increased astigmatism in contrast to 50% had decreased amount of astigmatism. It is also seen that the supero-temporal incision group had more number of patients (78%) with visual acuity better than 6/9 at 4th postoperative week than superior incision group (42%). Conclusion: This study concludes that superior incision cause more ATR astigmatism postoperatively whereas superotemporal incision causes lower magnitude of WTR astigmatism, which is advantageous for the elderly. Besides superotemporal incision provides better and early visual acuity postoperatively.


1970 ◽  
Vol 1 (2) ◽  
pp. 95-100 ◽  
Author(s):  
SK Singh ◽  
I Winter ◽  
L Surin

Background: Several studies have shown comparable visual outcomes of SICS and phacoemulsification (Gogate et al 2007, Ruit et al 2007). Objective: To compare the safety and efficacy of different types of surgical procedures (phacoemulsification versus SICS) for cataract surgery in immature cataract. Material and methods: A prospective randomized controlled trial was carried out involving 93 and 89 patients with immature senile cataract selected for phacoemulsification and SICS respectively. Statistics: Mean values with standard deviations were calculated. P value of less than 0.05 was considered significant. Results: There was no difference between the groups in terms of gender, age and pre-operative visual acuity (p = 0.09). In phacoemulsification group (n=93) more than two thirds and in SICS group (n=89) more than three quarters of the patients had good visual outcome (6/6-6/18) on first postoperative day (p=0.065). Poor outcome (<6/60) was recorded in 6% (phacoemulsification group) and 1% (small incision cataract surgery group). Mean visual acuity was 0.43 ± 0.27 in phacoemulsification group and 0.47 ± 0.24 in SICS group. Mean surgery time was significantly shorter in SICS group (p=0.0003). Statistics: Data were computed and analyzed using the SPSS software program vs 10. The p value of < 0.05 was considered significant. Conclusion: There was no significant difference in visual outcome on first post operative day in between phacoemulsification and SICS technique. However, performing SICS was significantly faster. Small incision cataract surgery with implantation of rigid PMMA lens is a suitable surgical technique to treat immature cataract in developing countries. Keywords: phacoemulsification; small incision cataract surgery (SICS) DOI: 10.3126/nepjoph.v1i2.3682 Nep J Oph 2009;1(2):95-100


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