scholarly journals Assessment of effectiveness of extracapsular cataract extraction versus manual small incision cataract surgery: an observational study

Author(s):  
Mohin M. Sakre ◽  
Sana Nizami ◽  
Ranjana Singh ◽  
Anuhya Raghavendra ◽  
Anant Arunrao Takalkar

Background: Dilemma of cost effectiveness of manual small incision cataract surgeries (MSICS) in the terms of training and equipment has been widely pondered upon in developing areas. Objective of the study is to compare the manual small incision cataract surgery and extra capsular cataract extraction.Methods: A prospective study was conducted among the IPD patients of the Ophthalmology Department of Khaja Bandanawaz Teaching and General Hospital, Kalaburagi, from June to December 2017. Statistical Analysis was performed using Microsoft Excel 2013, SPSS 23.0 and Chi-square test was performed.Results: Out of the 160 individuals who underwent extra capsular cataract extraction (ECCE), 06 (3.75%), 91 (56.88%) and 63 (39.37%) of the study subjects had poor (5/50), moderate (6/60-6/24) and good (6/18-6/6) visual acuity respectively. Highest incidence was that of lens prolapse (25%) and corneal complications (25%) in ECCE. Among the subjects who underwent MSICS, highest incidence of intra operative complication noticed was that of lens prolapse, iris prolapse and anterior chamber collapse, each at 20%.Conclusions: It was concluded that the restoration of visual acuity was fairly good and uniform in both the procedures. Certain intra operative complications such as lens prolapse, iris prolapse and anterior chamber collapse were noticed in MSICS and capsular flaps and vitreous loss were noticed only in ECCE.

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


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.


2006 ◽  
Vol 134 (3-4) ◽  
pp. 151-154
Author(s):  
Milos Jovanovic ◽  
Zoran Latkovic

The objective of this case report was to present the development of implantation cyst following the perforating corneal injury, the problems related to the treatment, including total surgical excision of the cyst, the secondary cataract extraction, iridoplasty and the artificial intraocular lens reposition. A patient first presented with perforating corneal injury inflicted by a piece of wood, with the iris prolapse. Primary wound management, reposition of prolapsed iris and corneal sutures were performed four days after the injury. Eight months later, the patient was rehospitalized due to an implantation iris cyst and traumatic cataract. The cyst was excised, the extracapsular cataract extraction was done and the anterior chamber lens was implanted. Postoperative visual acuity was normal. Three years later, the patient presented for a follow-up examination, with the cyst filled up again, occupying two thirds of the anterior chamber. This time, the cyst was completely excised, all fibrous remnants of the secondary cataract were removed, and the iridoplasty was necessary due to large iris coloboma. Reposition of the anterior chamber lens was carried out. Histological examination revealed an implantation iris cyst covered by multilayered squamous epithelium. Normal visual acuity was achieved. The patient has been followed-up for six months uneventfully. Management of perforating corneal wound with iris prolapse may lead to development of an implantation iris cyst. Puncture of the cyst as well as incomplete excision will not solve the problem. Complete surgical removal of the iris cyst is the treatment of choice.


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 22 (1) ◽  
pp. 132-135
Author(s):  
AKM Shahidur Rahman Tarafder ◽  
M Anwarul Kader ◽  
SM Rezaul Karim

To study "small incision cataract surgery (SICS)" for the rehabilitation of cataract visually impaired and blind patients, a retrospective study of 100 cases of cataract patients with small incision cataract surgery (SICS) with posterior chamber intraocular lens (PCIOL) implantation were done at Rajshahi Medical College Hospital. All cases were selected having corrected visual acuity less than 6/60 who were admitted at the Department of Ophthalmology for cataract surgery from March, 2006 to February, 2008. Age group of the patient range from 40 to 85 years. Age related senile cataract were selected any complicated cataract was excluded from the study. All these patients underwent SICS with 5.5 mm optic polymethylmethacrylate (PMMA) non-foldable posterior chamber intraocular lens (PCIOL) were implanted by irrigation vectis. Intra operative complication were present in 8% cases among them 3 cases (3%) required to conversion to Conventional Extracapsular Cataract Extraction (ECCE). 2 cases (2%) had small posterior capsular rent (PCR), 1 case (1%) irido dialysis & 2 cases (2%) hyphaema occurred. Postoperative complications were found in 38 cases (38%) among them transient corneal oedema occurred in 18 cases (18%) iritis occurred in 13 cases (13%), decentering of intraocular lens (IOL) occurred in 2 cases, corrected visual acuity after 6 weeks of operation were 6/12 or better in 97 cases (97% cases achieved functional vision). Induced astigmatism ± 0.50 D to ± 1.00 D occurred in 94 cases (94%) and ± 1.500 to 2.50D in 6 cases (6%). So, SICS may be the choice of surgery in respect of visual outcome with the limited facilities and surgeons. DOI: 10.3329/taj.v22i1.5037 TAJ 2009; 22(1): 132-135


2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Muhammad Ifraheem Khan ◽  
Saba Ali Arif ◽  
Muhammad Raja ◽  
Sheikh Ijaz ◽  
Muhammad Saeed Khan

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.


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