scholarly journals A study to assess the macular thickness and visual outcome before and after cataract surgery

Author(s):  
Abhishek Salwan ◽  
Shakeen Singh

Background: Cystoid macular edema (CME) is the formation of fluid-filled cystoid spaces between the outer plexiform and inner nuclear layers of the retina. It may present as a complication of routine cataract surgery including phacoemulsification (PHACO) and small incision cataract surgery (SICS).Methods: An observational study of uncomplicated cataract surgery with assessment by ophthalmoscopy, slit Lamp, Snellen chart and OCT during pre- and post-operative period. 100 patients were selected by inclusion criteria and using convenient sampling technique and were divided into two groups of 50 each in PHACO and SICS groups.Results: During preoperative observation in SICS/group-1, mean value and SD of macular thickness was 223.38±12.61 and in PHACO/group-2 it was 224.14±12.69. Mean value, mean difference and p value of visual acuity in group 1 was 0.258, during 12 weeks 0.788 with mean difference -0.53 and p=0.000 and in group 2 it was 0.269, during 12 weeks 0.844 with mean difference -0.58 and p=0.000. Mean value, SD, mean difference and p value of macular thickness in SICS during 1 week was 238.28±12.29, during 12 weeks 227.04±12.58 with mean difference 11.24000 and p=0.000 and in PHACO mean value, SD, mean difference with p value during 1 week was 231.90±12.42, during 12 weeks was 225.02±11.74 with mean difference 6.88000 and p=0.000.Conclusions: A subclinical increase in post-operative macular thickness was recorded which returned nearly to baseline values during the 12 weeks follow up and did not affect visual outcome.

Author(s):  
Mamta Singh ◽  
Bibhuti Prassan Sinha

Purpose: The main purpose of this study was to compare the macular thickness after uncomplicated Phacoemulsification versus manual SICS in known diabetic patient by OCT. Methods: This study was prospective observational study involving 50 eyes of 50 patients with each arm having 25 patients.  Group 1 was operated with Phacoemulsification with foldable IOL through 2.2 mm incision & group 2 were operated with manual SICS through 5.5 to 6.5 mm incision with PMMA IOL implantation. Macular OCT was performed in all patients during preoperative period & day 7 post op, 1st month, 3rd month & 6th month. The data were analyzed by using SPSS software (version22.0 SPSS Inc). Results: The MCFT rose steadily in both group during post operative period with higher rise noted in SICS group throughout follow up. Significant difference in MCFT between Phaco & SICS group were noted with highest MCFT noted in 1st month follow up in both groups i.e.  231.6 micro m (SD+7.831) in Phaco group & 241.08 (SD+7.35) in SICS group. The MCFT returned to near pre OP value by 6th month. Conclusion: 1 Age & Sex has no effect on macular thickness before and after any type of Cataract surgery be it Phaco or SICS. 2 Significant higher macular thickness was observed in SICS group so       caution should be taken in SICS patients. Keywords: Phacoemulsification, small incision cataract surgery (SICS), Cystoid macular edema


2020 ◽  
pp. 173-176
Author(s):  
Kinjal Rathod ◽  
Kinjal Trivedi ◽  
Snehal Nayi ◽  
Somesh Aggarwal

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.


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


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


2019 ◽  
pp. 1-3
Author(s):  
Ritu Agarwal ◽  
Piyush Gupta*

AIM: To evaluate and compare macular thickness changes after uneventful Phacoemulsification and Manual Small Incision Cataract Surgery in correlation with visual acuity. METHOD: Study was conducted on 250 cataract patients they were equally divided into Group A and Group B. Group A patients underwent Phacoemulsification and Group B underwent MSICS. In both groups macular thickness using OCTand Best Corrected Visual Acuity (BCVA) was recorded preoperatively and postoperatively at 1 day, 1, 3, 6 weeks, 3 and 6 months. Macular thickness changes were evaluated and compared with visual acuity. RESULTS: Macular thickness continued to increase from 1 week to 6 months postoperatively which was statistically significant. No correlation found between increased macular thickness and BCVA. CONCLUSION: Increase in macular thickness remained subclinical and there was no impact of increased macular thickness on the final visual outcome.


2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S448-51
Author(s):  
Syed Muhammad Asad Shabbir Bukhari ◽  
Sohail Aslam ◽  
Naeem Riaz ◽  
Muhammad Waqas Ayub ◽  
Irfan Saeed ◽  
...  

Objective: To compare the recovery of patients in both groups having acute otitis externa induced by cotton buds/various objects. One group by old method and second group by unique method. Study Design: Quasi-experimental study. Place and Duration of Study: Pakistan Naval Ship Shifa Karachi, from Jan to Dec 2020. Methodology: Non-probability convenience sampling technique was applied. Out of 50 cases were selected for group 1 management. Fifty cases were selected for group 2 management. A chi-square test was applied to compare the recovery of two groups of patients on the 14th day and 42nd day of follow-up. p-value was kept 0.05 as significant. Results: A total of 100 cases were treated in 2 groups. The gender distribution of the study was 54 females and 46 males. The mean age of the study population was 33.09 ± 12.93 years. p-value was calculated on the 14th day and 42nd days. A 2x2 table of 14th follow up day showed recovery by both groups with a p-value of 0.041 which is <0.05. This showed that group 2 management was statistically better than group 1 management. Conclusion: The second group was managed with eardrops containing Betamethasone and Neomycin. This management protocol is unique and better than conventional management as done in the first group.


2016 ◽  
Vol 10 (1) ◽  
pp. 119-125
Author(s):  
Roseline E. Duke ◽  
Adedayo Adio ◽  
Sidney K. Oparah ◽  
Friday Odey ◽  
Okon A. Eyo

Purpose: A retrospective study of the outcome of congenital and developmental cataract surgery was conducted in a public child eye health tertiary facility in children <16 years of age in Southern Nigeria, as part of an evaluation. Materials and Method: Manual Small Incision Cataract Surgery with or without anterior vitrectomy was performed. The outcome measures were visual acuity (VA) and change (gain) in visual acuity. The age of the child at onset, duration of delay in presentation, ocular co-morbidity, non ocular co-morbidity, gender, and pre operative visual acuity were matched with postoperative visual acuity. A total of 66 children were studied for a period of six weeks following surgery. Results: Forty eight (72.7%) children had bilateral congenital cataracts and 18 (27.3%) children had bilateral developmental cataracts. There were 38(57.6%) males and 28 (42.4%) females in the study. Thirty Five (53%) children had good visual outcome (normal vision range 6/6/ -6/18) post-operatively. The number of children with blindness (vision <3/60) decreased from 61 (92.4%) pre-operatively to 4 (6.1%) post-operatively. Post operative complication occurred in 6.8% of cases six week after surgery. Delayed presentation had an inverse relationship with change (gain) in visual acuity (r = - 0.342; p-value = 0.005). Pre-operative visual acuity had a positive relationship with post operative change (gain) in visual acuity (r = 0.618; p-value = 0.000). Conclusion: Predictors of change in visual acuity in our study were; delayed presentation and pre-operative VA. Cataract surgery in children showed clinical benefit.


Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Shaukat Hussain ◽  
Muhammad Arslan ◽  
Muhammad Tayyab ◽  
Isfand Yar Khan

Objective: To compare the outcome of salbutamol nebulization with controls (normal saline) in transient tachypnea of newborn. Methods: In this randomized controlled trial 284 (142 in each group) neonates were included with gestational age above 35 weeks of any gender. Study was conducted in Department of Pediatrics Holy Family Hospital Rawalpindi. Sampling technique was consecutive non probability sampling. Duration of study was 6 months. Sample size had been calculated using WHO calculator; Significance level 5%, Power of test 80%, Population mean 5.4, Test value of population mean 4.8, Standard Deviation 1.8. At admission complete blood picture, C-reactive protein and chest x-ray were done. Group-1 received salbutamol nebulization at a dose of 0.15mg / kg / dose for 10 minutes in 2ml normal saline QID while Group-2 received only normal saline nebulization 2ml QID in 24 hours. Double blinding was ensured and in case of any side effects of salbutamol (tachycardia, arrhythmias and hypoglycemia) treatment was stopped immediately and managed accordingly. Results: In this study, comparison of outcome of inhaled salbutamol with controls in transient tachypnea of newborn shows that respiratory rate per minute was 50.15+2.34 in Group-1 and 64.92+2.70 in Group-2, p value was 0.0001, heart rate per minute in Group-1 was recorded as 120.08+2.36 and 134.79+3.27 in Group- 2, p value was 0.0001, oxygen saturation(%) was 97.27+0.92 in Group-1 and 83.28+1.81 in Group-2, p value was 0.0001, duration of oxygen therapy(hours) was recorded as 15.49+1.84 in Group-1 and 27.78+5.57 in Group-2, value of p was 0.0001, duration of hospitalization(days) was recorded as 2.03+0.45 in Group-1 and 5.07+0.72 in Group-2 while value of P was 0.0001 Conclusion: Salbutamol Nebulization is more effective than normal saline in TTN. Key Words: Transient Tachypnea of newborn, management, inhaled salbutamol, outcome.


2018 ◽  
Vol 6 (3) ◽  
pp. 12
Author(s):  
Ni Wayan Wahyuningsih ◽  
Nila Wahyuni ◽  
Luh Made Indah Sri Handari Adiputra

ABSTRACT Non-spesific neck pain is one of disorder among general population including tailors in Subdistric Kuta. Therefore the need for a therapy that can be given as myofascial release technique, mulligan mobilization, and infrared. The design of this study was experimental with pre-test and post-test group design. The technique sampling was purposive sampling technique. The samples were divided into 2 groups. Group 1 was given Myofascial Release Technique and Infrared, while Group 2 was given Mulligan Mobilization and Infrared. The range of motion is measured by goniometer. The result showed no significant difference between Group 1 and Grpu[ 2 in which p value = 0.250 (p>0.05) with 56.8% in the Group 1 and 60.8% in the Group 2. Based on result , it can be concluded that Myofascial Release Technique and Infrared show no significant difference with Mulligan Mobilization and Infrared to increase range of motion of the neck on the non-spesific neck pain. Keywords : non-spesific neck pain, myofascial release technique, mulligan mobilization, infrared.


1970 ◽  
Vol 4 (1) ◽  
pp. 37-44 ◽  
Author(s):  
JB Ale ◽  
J Power ◽  
K Zohs ◽  
F Cunningham

Purpose: To evaluate the refractive and visual outcome of toric IOL implantation for correction of pre-existing corneal astigmatism following cataract surgery. Materials and methods: In this retrospective study, 56 eyes of 30 patients who underwent implantation of toric IOL following regular phacoemulsification were divided into two groups based on the types of toric IOL implanted: group 1 patients received Acrysof toric (Alcon) and group 2 patients received AT-Torbi (Zeiss Meditech) IOLs. Pre-and post-operative corneal and refractive astigmatisms, and post-operative distance vision were investigated. Statistical analysis was carried out using the paired student t-test when necessary. Factors affecting the success of toric IOL implantation are discussed and recommendations are made to optimize the outcome. Results: The mean age of all patients was 75.56 ± 9.87 years. No statistical difference was observed between pre-and post-operative corneal astigmatism (p = 0.819). Postoperative refractive astigmatism was significantly less in both groups (Group 1: p = 0.0014; Group 2: p=<0.00001). The best-corrected distance visual acuity was 6/12 or better in 95 % of group 1 and 100 % of group 2 patients. Conclusion: Toric IOL implantation is a viable and highly predictable method of correcting the corneal astigmatism. It allows correction without compromising the integrity of the cornea. Careful selection of the patient, accurate keratometry and precise alignment of the cylindrical axes are some of the factors to be considered for a superior outcome. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5848 NEPJOPH 2012; 4(1): 37-44


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