Ocular Clinical Spectrum of Pseudoexfoliation in Cataract Patients at a Tertiary Eye Care Centre in Rural Maharashtra – A Cross Sectional Study

2021 ◽  
Vol 8 (8) ◽  
pp. 450-455
Author(s):  
Varsha Ramesh Dhakne ◽  
Sourabh Hanumant Karad ◽  
Hanumant Tulshiram Karad ◽  
Samarth Babasaheb Waghambare ◽  
Madhuri Tejas Karad ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Central Zone ◽  
Peripheral Zone ◽  
Detailed Examination ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Postoperative Result ◽  
Intraoperative Care ◽  
Clinical Variants ◽  
Cataract Patients

BACKGROUND Pseudoexfoliation (PEX) is a systemic microfibrillopathy characterised by accumulation of gray-white fibrogranular extracellular material over the lens, pupil or cornea. Different clinical variants of PEX in cataract patients are known to occur. We wanted to study the different clinical variants of PEX in cataract patients, the intraoperative and postoperative complications and the visual prognosis of cataract surgery. METHODS A total of 100 patients with PEX in cataract were subjected to detailed examination and necessary investigations. Cataract surgery was performed in all patients using the manual small incision cataract surgery (SICS). Vision before and after surgery was recorded. Refraction was done and documented. Best corrected visual acuity was noted and was followed-up postoperatively for 2 – 4 weeks. RESULTS Maximum prevalence of PEX (57 %) was seen in 51 - 60 years of age and 64 % were males and 36 % were females. The involvement was bilateral in 53 % and unilateral in 47 % cases. The range of intraocular pressure (IOP) was 12.4 mm Hg to 23.1 mm Hg. 67 % patients had insufficient mydriasis and 81 % cases were found to have PEX material deposited on the peripheral zone and 19 % cases on both peripheral zone and central zone. A total of 27 % cases had mature cataract and 7 % had hypermature cataract. CONCLUSIONS PEX requires a thorough preoperative planning along with a proper intraoperative care to ensure an uneventful surgery and a successful postoperative result. KEYWORDS Pseudoexfoliation, Mydriasis, Cataract

scholarly journals Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Cataract Surgery ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Uncorrected Visual Acuity

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.

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 Tarif Pelayanan Pembedahan Katarak Pasien Jaminan Kesehatan Nasional dengan Teknik Fakoemulsifikasi dan Small Incision Cataract Surgery

2020 ◽  
pp. 193-202
Author(s):  
Riris Dian Hardiani ◽  
Tris Eryando
Keyword(s):  
Cataract Surgery ◽  
National Health ◽  
Social Insurance ◽  
Claim Data ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Average Hospital ◽  
Small Incision ◽  
Case Base

Abstrak Prevalensi kebutaan di Indonesia karena katarak pada penduduk berusia ≥ 50 tahun sebesar 3% dan salah satu biaya kesehatan terbesar di tahun 2017 adalah untuk pembedahan katarak. Untuk melakukan pembandingan tarif rumah sakit serta tarif Indonesian Case Base Groups (INA-CBG) pelayanan pembedahan katarak dengan teknik fakoemulsifikasi dan Small Incision Cataract Surgery (SICS) dilakukan penelitian potong lintang menggunakan data klaim Jaminan Kesehatan Nasional (JKN) Rumah Sakit “X”. Perbedaan tarif fakoemulsifikasi dan SICS dianalisis secara bivariat dengan Mann-Whitney. Dari 1278 pasien katarak, terbanyak adalah pasien laki laki, berumur ≥ 60 tahun, 84,7% pembedahan menggunakan teknik fakoemulsifikasi, dan 77,2% pembedahan dilakukan di rawat jalan. Untuk pelayanan rawat inap, fakoemulsifikasi terbanyak di ruang perawatan kelas 1 (50,0%) dan SICS di kelas 3 (65,4%). Rerata tarif rumah sakit untuk rawat jalan fakoemulsifikasi Rp 9.536.041,- ±1.336.734,03 dan SICS adalah Rp 7.438.924,- ±1.160.666,63 (p<0,05) sedangkan untuk rawat inap fakoemulsfikasi Rp 9.355.253,- ±2.288.647,36 dan SICS Rp 6.078.391,- ±1.854.308,65 (p<0,05). Rerata tarif INA-CBG fakoemulsifikasi rawat jalan adalah Rp 8.809.191,- ±218.193,55 dan SICS Rp 4.410.000 (p<0,05) sedangkan untuk rawat inap fakoemulsfikasi Rp 10.834.039,- ±2.019.676,19 dan SICS Rp 9.074.188 ±1.638.329,7 (p<0,05). Rerata tarif rumah sakit dan tarif INA-CBG untuk teknik pembedahan katarak dengan SICS baik rawat jalan maupun rawat inap lebih rendah dibandingkan dengan teknik fakoemulsifikasi. Tarif INA-CBG yang dibayarkan Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan untuk kedua metode pembedahan katarak pada pelayanan rawat jalan lebih rendah sedangkan untuk rawat inap lebih tinggi dibandingkan dengan tarif rumah sakit. Kata kunci: Fakoemulsifikasi, SICS, Katarak, JKN Abstract The prevalence of blindness in Indonesia due to cataracts in the population aged 50 years and above is 3%. However, one of the highest health costs in 2017 was on cataract surgery. To compare hospital tariff and Indonesian Case Base Groups (INA-CBG) tariff of phacoemulsification and Small Incision Cataract Surgery (SICS), a cross-sectional study was conducted using National Health lnsurance claim data at Hospital “X”. The differences between phacoemulsification and SICS tariff were analyzed using the Mann-Whitney test. From a total of 1278 patients, majority were males, aged 60 years and above. 84.7% of the patients went through a phacoemulsification procedure, 77.2% were outpatients. Most inpatients that went through a phacoemulsification were admitted to class 1 wards (50.0%) while a majority of those went through a SICS procedure were admitted to class 3 wards (65.4%). There were significant differences in the average hospital tariff between phacoemulsification and SICS for both outpatients’ (IDR 9,536,041 ±1,336,734.03 vs IDR 7,438,924 ±1,160,666.63;p<0.05) and inpatients’ (IDR 9,355,253 ±2,288,647.36 vs IDR 6,078,391 ±1,854,308.65; p<0.05) care. The average INA-CBG tariff also had significant differences between both procedures for outpatients’ care (phacoemulsification vs SICS: IDR 8,809,191 ±218,193.55 vs IDR 4,410,000;p<0.05) and inpatients’ care (IDR 10,834,039 ±2,019,676.19 vs IDR 9,074,188 ±1,638,329.7; p<0.05). The average hospital and INA-CBG tariff of SICS, for both outpatients and inpatients were lower than that of phacoemulsification. Although INA-CBG tariffs paid by the Social Insurance Administration Organization for Health or BPJS Kesehatan for both phacoemulsification and SICS procedures in outpatients was lower, the INA-CBG inpatients’ tariff was higher than the hospital tariff. Keywords: Phacoemulsification, SCIS, Cataracts, National Health Insurance (NHI)

scholarly journals Phacoemulsification: Awareness among Postoperative Cataract Patients in South East Nigeria

2021 ◽  
pp. 84-89
Author(s):  
Arinze Anthony Onwuegbuna ◽  
Akunne Ijeoma Apakama ◽  
Ejike Ekene Igboegwu ◽  
Emeka Akujuobi Chianakwalam ◽  
Miriam-Benigna Chika Amobi ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Formal Education ◽  
Tertiary Education ◽  
Modern Method ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Anambra State ◽  
Male Female Ratio ◽  
Cataract Patients

Objective: To determine the awareness of phacoemulsification among post operative cataract patients. Methods: This was a prospective descriptive cross-sectional study to assess the knowledge of phacoemulsification among postoperative cataract patients that presented in community eye care outreaches in 3 local government areas of Anambra State Nigeria between June 21st 2021 to June 25th 2021. Results: The total number of people that attended the outreaches during the study period were 975. Out of these, 167 participants had cataract surgery but only 155 (n=155/167) consented to the study, giving a response rate of 92.8%. The mean age was 67±13 years with an age range of 18 to 93 years. The male: female ratio was 1: 1.2. There were more females (n=84/155, 54.2%) than males (n=71/155, 45.8%).Majority obtained only primary education (n=74/155, 47.7%), while 20.6% (n=32/155) obtained secondary education, 14.2% (n=22/155) obtained tertiary education while 17.4% (n=27/155) had no formal education Conclusion: Most cataract blind people in Nigeria are not aware of phacoemulsification cataract surgery and therefore may limit options for modern treatment of cataract blindness, even though this modern method of cataract treatment has been in place for decades in other countries.

scholarly journals Outcomes of manual Small Incision Cataract Surgery (mSICS) compared with phacoemulsification from population based outreach eye camp, in Yogyakarta and Southern Central Java Region, Indonesia

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Indra Tri Mahayana ◽  
Reny Setyowati ◽  
Tri Winarti ◽  
Suhardjo Prawiroranu
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
High Volume ◽  
Outreach Program ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Surgical Adverse Events

In this study, we compared the effectiveness (comparison of post-operative visual acuity/VA) of phacoemulsification by ophthalmologists versus manual small incision cataract surgery (mSICS) by residents in a mass cataract surgery setting. This research was a cross-sectional study of 1137 cataract patients who underwent cataract surgery by ophthalmologists and residents in outreach eye camps during 2015-2017 (3 years). There were 554 patients who underwent phacoemulsification by ophthalmologists and 583 patients who underwent mSICS by residents. Basic patient characteristics data, such as: age, sex and pre-surgical VA were recorded and we compared pre- versus post-operative VA (best corrected VA/BCVA) and surgical adverse events in 4 weeks post-operative follow-up. In basic subject characteristics, there were no differences in age and sex between the 2 groups, in which 602 (52.9%) were men and 535 (47.1%) were women. Overall 583 (51.3%) eyes received mSICS and 554 (48,7%) eyes received phacoemulsification. Visual acuity improvement (≥6/18) was achieved in 59.61% of eyes after phacoemulsification and 53.5% eyes after mSICS. There were no statistical differences in visual outcome results between both groups (p=0.10). Severe surgical adverse events (nucleus drop and endophthalmitis) were found in 3 cases (0.26%) and choroidal bleeding in 1 eye (0.08%). The effectiveness of phacoemulsification and mSICS in improving visual acuity was found similar between ophthalmologists and residents. mSICS should be considered for more frequent use in high volume mass cataract surgery.KEYWORDS cataract surgery; phacoemulsification; manual small incision cataract surgery; outreach program; community ophthalmology

scholarly journals Intra-Operative and Immediate Post-Operative Complications of Cataract Surgery in an Eye Camp

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Asad Azeem Mirza ◽  
Saba Al Khairy ◽  
Mazhar- Ul-Hassan ◽  
Shahid Azeem Mirza ◽  
Saad Aslam ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Cataract Extraction ◽  
P Value ◽  
Extracapsular Cataract Extraction ◽  
Small Incision Cataract Surgery ◽  
Common Procedure ◽  
Cross Sectional ◽  
Operative Complication ◽  
Operative Complications ◽  
Post Operative Complications

Purpose: To analyze the intra-operative and immediate post-operative complications in patients after cataractsurgery in an eye camp.Study Design: Descriptive cross-sectional study.Place and Duration of Study: The study was conducted in a village of Nawabshah, Sindh, Pakistan from 7th to9th of February 2020.Material and Methods: Fifteen hundred patients were screened for visual disabilities of which 150 were selectedfor the study. They had a visual acuity of less than 6/9 in one or both eyes and had a cataract. The selectedpatients were operated using either phacoemulsification, extracapsular cataract extraction ECCE), intracapsularcataract extraction (ICCE) or small incision cataract surgery (SICS). The immediate intra-operative as well aspost-operative complications on day 1 after surgery were observed.Results: One hundred and fifty patients were operated. Age ranged from 14 years to 90 years, males were58.7% and females were 41.3%. The most common procedure performed was phacoemulsification 51.3%,followed by ECCE 30.0%, then SICS 18.0% and ICCE 0.7%. The most common intra-operative complication wasposterior capsule rent and the most common post-operative complication was striate keratopathy which was seenin 14.0% individuals. There was a significant association found for post-operative complications with gender withfemales having more post-operative complications as compared to males (P-value = 0.001 < 0.001).Conclusion: Camp surgeries when performed with strict sterilization and in experienced hands can play animportant role in treating cataract, which is the commonest cause of preventable blindness in developingcountries

scholarly journals Seroprevalence of HIV infection among cataract surgery patients in south-east Nigeria: A retrospective cross-sectional study

2021 ◽  
Vol 3 (2) ◽  
pp. 001-008
Author(s):  
Arinze Anthony Onwuegbuna ◽  
Akunne Ijeoma Apakama ◽  
Chuka Michael Okosa ◽  
Emeka Akujuobi Chianakwalam ◽  
Miriam-Benigna Chika Amobi ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Cataract Surgery ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Cataract Patients

Background: Human Immunodeficiency Virus remains an important cause of morbidity and mortality especially in sub-Saharan Africa. Despite the availability of highly active antiretroviral therapy, many people with this disease still present with its ocular complications. Cataracts remain the commonest reason for blindness in Nigeria and globally. The prevalence of HIV infection among cataract patients in south east Nigeria has remained unknown. Objectives: To determine the prevalence of human immunodeficiency virus among cataract patients in south east Nigeria. Materials and Methods: This was a retrospective cross-sectional study. The case files of all who had cataract surgery between September 1st, 2020 to March 31st, 2021 at City of Refuge Specialist Eye Clinic Onitsha, Nigeria was obtained from the Medical Record Department of the hospital to extract relevant information and demographic data. The outcome measures included the prevalence of HIV, as well as the gender and the age of affected cataract patients. Data was analyzed using SPSS 26.0 IBM Corporation. Fisher’s exact test was performed for categorical data, and Student’s t-test was applied to continuous variables depending on their distribution. A p value of <0.05 was considered statistically significant. Results: In this study, 423 participants who underwent cataract surgery were included for analysis of which 16 were HIV positive. The overall seroprevalence of HIV among the study population was 3.78% with HIV prevalence showing the female to male ratio of 1:1. Up to 70.81% of the patients were at least 60 years of age. Although there was a statistically significant difference between the prevalence of HIV and seasonal presentation (p=0.015), there was no statistically significant relationship between the participants age and gender (p=0.195), prevalence of HIV and the participants’ age categories (p=0.149) or participants’ settlements (p=0.219). Conclusion: The prevalence of HIV among cataract patients in this study was 3.78%. This study confirms that HIV infections are an important public problem among cataract patients in Nigeria. Our findings draw attention to the significant burden HIV has on cataract surgery in Nigeria. We recommend advocacy for the national policymakers to initiate HIV tests in routine ophthalmology services.

scholarly journals Anxiety in Cataract Patients, Benefits of Counseling on Patient Anxiety in Routine Cataract Surgery

2020 ◽  
Vol 11 (2) ◽  
pp. 2620-2625
Author(s):  
Sonal Muley ◽  
Chetan Saoji ◽  
Sachin Daigavane ◽  
Ragini Patil ◽  
Ajinkya S. Ghogare
Keyword(s):  
Cataract Surgery ◽  
Research Centre ◽  
Patient Anxiety ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Medical College ◽  
Preoperative Stage ◽  
Peribulbar Block ◽  
Sectional Analysis ◽  
First Time

To quantify the anxiety provoked by cataract surgery and to assess which stage has caused maximum anxiety (preoperatively, operation day, postoperative day) and if counselling in the preoperative stage after admission helped in alleviating the fears of the patient.Ophthalmology Department at Datta Meghe Medical College, Shalinitai Meghe Hospital and Research Centre, Nagpur in collaboration with Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe) Wardha, Maharashtra.A cross-sectional analysis of patients having routine cataract surgery under local anaesthesia. The hospital anxiety and depression (HAD) scale was used to quantify the patient’s anxiety. All patients were operated by manual small incision cataract surgery under peribulbar block.50 patients (22 males and 28 females) were enrolled in the study. Patients were divided into two groups: patients getting operated for the first time (35 patients) and second time(15 patients).Highest anxiety in both the groups was found on the preoperative group before counselling. Females were found to be more anxious than in males though not statistically significant.Pre-operative anxiety was significantly more in patients getting operated for the first time than n patients getting operated for the second eye(p=0.06).Post-operative anxiety in second eye patients was significantly more than in first eye patients(p-0.0003).Patients were not unduly anxious during any stage of the treatment. Patients scheduled for second eye had overall lesser anxiety than patients scheduled for first eye cataract surgery. Counselling helped in alleviating the fears of the patient and resulted in reduction of HAD score for anxiety.

Sign in / Sign up

Export Citation Format

Share Document