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 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 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 Impact of Ophthalmic Viscosurgical Devices in Cataract Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-17
Author(s):  
Monali S. Malvankar-Mehta ◽  
Angel Fu ◽  
Yasoda Subramanian ◽  
Cindy Hutnik
Keyword(s):  
Cataract Surgery ◽  
Meta Analysis ◽  
Grey Literature ◽  
Database Search ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Soft Shell ◽  
Standardized Mean Difference

Background. Ophthalmic viscoelastic devices (OVDs) used during small-incision cataract surgery have numerous advantages. However, OVDs have longer retention time in an eye after surgery resulting in intraocular pressure (IOP) spikes. The purpose of this study is to analyze and quantify the effect of various OVDs on both IOP and best corrected visual acuity (BCVA) by systematically reviewing the literature and performing meta-analysis. Methods. Numerous databases from January 1, 1985, to present were systematically searched. Thirty-six (3893 subjects) of 3313 studies identified were included for analysis. Standardized mean difference (SMD) was computed, and meta-analysis was performed. Results. A total of 3313 records were retrieved including 1114 from database search and 2199 from grey literature search. Significant increase in postoperative IOP in 1-day follow-up with Healon (SMD = 0.37, CI: [0.07, 0.67]), Viscoat (SMD = 0.29, CI: [0.13, 0.45]), Provisc (SMD = 0.46, CI: [0.17, 0.76]), and Soft Shell (SMD = 0.58, CI: [0.30, 0.86]) was computed. On the other hand, results implied a nonsignificant increase in postoperative IOP with Healon GV (SMD = 0.07, CI: [−0.28, 0.41]), Healon5 (SMD = 0.15, CI: [−0.33, 0.64]), 2% HPMC (SMD = 0.32, CI: [−0.0, 0.64]), and OcuCoat (SMD = 0.26, CI: [−0.37, 0.9]). Additionally, a nonsignificant reduction in postoperative IOP was inferred with Viscoat + Provisc (SMD = −0.28, CI: [−2.23, 1.68]). Conclusion. Improvement in IOP was shown with Viscoat + Provisc. Additionally, IOP nonsignificant upsurge was observed with Healon GV, Healon5, 2% HPMC, and OcuCoat compared to significant upsurge with Healon, Viscoat, and Soft Shell.

A study of evaluation of anterior segment changes in eyes with pseudo exfoliation syndrome including anterior chamber depth status of lens anterior chamber angle preoperatively

2021 ◽  
Vol 19 (3) ◽  
pp. 38-44
Author(s):  
Girish Surlikar ◽  
Keyword(s):  
Cataract Surgery ◽  
Anterior Chamber ◽  
Intraoperative Complications ◽  
Systemic Disease ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Visual Outcome ◽  
Pseudoexfoliation Syndrome ◽  
Small Incision Cataract Surgery ◽  
Small Incision

Background: Pseudoexfoliation syndrome is an important ocular manifestation of a systemic disease, found to be common in cataract patients as well as in 50% of glaucoma patients. Present study was intended to assess the profile of Pseudoexfoliation syndrome and evaluate the surgical outcome of Manual Small Incision Cataract Surgery in Pseudoexfoliative eyes. Material and Methods: Present study was prospective, observational, hospital-based study, conducted in patients with age more than 50 years, with Pseudoexfoliation, admitted for cataract surgery, posted for Manual Small incision cataract surgery(MSICS). All patients underwent a manual small incision cataract surgery, and visual outcomes of the procedures were recorded on the first postoperative day. Results: In present study, maximum numbers of patients were from the age group of 70-79 years (62.5%) and 56 (70%) patients were males and 24 (30%) were females. In this study of 80 patients with Pseudoexfoliation Syndrome, 60 patients had Bilateral Pseudoexfoliation i.e. 120 eyes (85.71%) while 20 patients had Unilateral Pseudoexfoliation i.e. 20 eyes (14.29%). In majority of the eyes 111 (79.29%) had involvement of lens with Pseudoexfoliation while 109 (77.86%) had pupillary involvement. Mean Anterior Chamber Depth in Pseudoexfoliative eyes was 2.50±0.22 mm. Majority of the eyes i.e. 74 (52.9%) were having IOP between 16 – 20 mm Hg. 61 eyes (43.6%) had IOP between 11 – 15 mm Hg. 80 eyes of 80 patients underwent MSICS, 17 (21.25%) patients developed Intraoperative Complications. Conclusion: There is significant association between Pseudoexfoliation syndrome and age, male preponderance and bilateral involvement of eyes. MSICS provides significant improvement in visual outcome in patients with Pseudoexfoliation syndrome with cataract.

A Descriptive Study of Intraoperative Complications in Manual Small Incision Cataract Surgery

2021 ◽  
Vol 8 (2) ◽  
pp. 75-79
Author(s):  
Dr. Divya Khatwani ◽  
Dr. Ajay Tammewar ◽  
Dr. Sneha Murade ◽  
Dr. Roopa Naik
Keyword(s):  
Developing Countries ◽  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Cataract Extraction ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Study Results ◽  
Developed World

Background: Senile cataract is the most common cause of reversible blindness in India and other developing countries. It is one of the significant social problem. Though phacoemulsification has become a routine procedure for cataract extraction in most parts of the developed world, it is not always appropriate either for its cost or the density of cataract involved in developing nations like India. Small incision cataract surgery is commonly performed surgery in developing countries. This procedure is safe, effective to increase the surgical outcome, reduces surgical time, easier to maintain instrumentation and at the same time affordable. The present study is undertaken to study the intraoperative complications and how best these complications can be minimized and managed. Methods: A total of 50 cases were studied from October 2020-January 2021. It is a hospital based, descriptive cross sectional study. Results: Intraoperative complications occurred in 10 cases (20%). It included iris prolapse in 3 cases (6%), tunnel related complications in 3 cases which included premature entry in 2 cases (4%) and button holing in 1 case (2%), Descemet membrane detachment in 1 case (2%), intraoperative miosis in 1 case (2%), intraoperative hyphema in 1 case (2%), capsule related complications in 1 case (2%) and PC rent in one case (2%). Conclusion: Over all the intraoperative complications of manual small incision cataract surgery are less and the procedure is well suited in our country, where there is a large number of backlog of cataract cases.

scholarly journals A Clinical Study Comparing Different Techniques of Nucleus Delivery in Manual Small Incision Cataract Surgery

2015 ◽  
Vol 2 (2) ◽  
pp. 67
Author(s):  
Mrunal Suresh Patil ◽  
Dhiraj Namdeo Balwir ◽  
Amal Gupta ◽  
Ishan Kataria ◽  
Sumit Chatterjee
Keyword(s):  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Group 2 ◽  
Grade 3 ◽  
Posterior Chamber Iol ◽  
Group 1

<strong>Aim</strong>: To compare different technique of nucleus delivery in small manual incision cataract surgery,regarding their safety and intra operative complication. <strong>Material &amp; Methods</strong>: A total of 285 patients with cataract undergoing SICS with posterior chamber IOL implantation were selected. Patients were randomly divided into 7 groups of nucleus delivery. All of the patients were followed up on first postoperative day and discharge. Patients were advised regular follow up at 1<sup>st</sup> week, 4<sup>th</sup> week and 6<sup>th</sup> week. <strong>Results</strong>: Out of total 285 patients 68 (23.86%) patients had intraoprative complications for all the techniques. There was no intraoperative difficulty to the surgeon for delivery of nucleus by various techniques in 210(73.68%) of cases. Group 1 (wire vectis) had minimum intraoperative complications whereas group 2 had maximum.31 (10.88%)had grade 1 (minimal) difficulty intraoperetively. 25 (8.77%)cases had grade 2 (moderate) difficulty. 19 (6.67) cases had grade 3(abandoned) difficulty. <strong>Conclusion</strong>: By adjusting parameters like size of cornean incision, hydrodissection or debulking of nucleus before delivery of nucleus in different grades of hardness of cataract, a surgeon may choose any one technique in which he or she is comfortable. Manual small incision Cataract surgery with its low complication rate has now come to be established surgical procedures for cataract surgery.

scholarly journals Sub-conjunctival dislocation of posterior chamber intra-ocular lens: five years after manual, small-incision cataract surgery

2014 ◽  
Vol 6 (1) ◽  
pp. 91-94
Author(s):  
Rajesh Subhash Joshi
Keyword(s):  
Cataract Surgery ◽  
Wound Closure ◽  
Wound Dehiscence ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Scleral Tunnel ◽  
Posterior Chamber Intraocular Lens

Introduction: Ocular trauma can cause serious complications in eyes operated for cataract. Case: A 70-year- old lady had sustained blunt trauma to the left lower lid which resulted in a sub-conjunctival dislocation of the posterior chamber intraocular lens (PCIOL). The patient had undergone an uneventful manual, small-incision, sutureless cataract surgery with implantation of a PCIOL for senile cataract five years ago in the same eye. She had no ocular or systemic predisposing factors for wound dehiscence. Surgical exploration revealed a scleral rupture 7 mm in length, 2 mm behind the limbus at the 12’O clock position along the surgically-constructed wound. However, the scleral tunnel was not damaged. The PCIOL was removed. Wound closure was done to avoid infection of the intraocular structures. Her best-corrected visual acuity was 20/60 at the three months’ follow-up. Conclusion: Surgeons should be aware of such complications occurring due to trauma. We recommend suturing of the scleral wound to strengthen it in cases of a deep scleral groove or when there is a possibility of a premature entry of the wound into the anterior chamber. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10777   Nepal J Ophthalmol 2014; 6 (2): 91-94

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