COMPARISON OF VISION OUTCOMES BETWEEN SICS (SMALL-INCISION CATARACT SURGERY) AND PHACOEMULSIFICATION IN CATARACT SURGERY

Author(s):  
NAVYA SAI K ◽  
SUHAS REDDY C ◽  
SRILEKHA K ◽  
AVANTHI PRIYA K

Objectives: The main objective of the study is to compare the vision outcomes between small-incision cataract surgery (SICS) and phacoemulsification (PHACO) procedures, to compare the quality of life (QOL) before surgery and after surgery, to improve the patient’s knowledge of their disease condition, and to increase medication adherence after the surgery. Methods: A prospective observational study was conducted for 6 months. About 100 patients were enrolled in the study according to the study criteria. Different scales ([visual function questionnaire] VFQ 25, QOL scale [QOLS] by Schalock and Keith, Morisky Adherence Scale -8 items) were scored from the patient’s profile and treatment chart by communicating with physicians, counseling the patients. Results: One hundred patients were assessed before and after cataract surgery and follow-up was made for 1 month. Overall, vision-related QOL was significantly improved in PHACO than SICS patients. National Eye Institute VFQ 25 was assessed on day 7 and day 30 where we have observed a statistically significant improvement in the PHACO group of patients than in SICS. Their medication adherence scores were categorized into a high, medium, low category, and most of the SICS patients remained in the medium category, whereas the number of patients increased from medium to high category in PHACO patients. Conclusion: We concluded that PHACO is better than small incisional cataract surgery due to its small and self-sealing incision, which requires no stitches in most cases, with minimum complications the patient heals faster and recovers rapidly.

2021 ◽  
Vol 8 (7) ◽  
pp. 468-472
Author(s):  
Saswati Biswas ◽  
Santosh Yadawrao Ingle ◽  
Samiran Das

Background: The main aim of the study is to compare the change in macular thickness after uncomplicated phacoemulsification versus uncomplicated manual SICS in known diabetic patients by optical coherence tomography Methods: This study was an observational study involving 50 patients with each group having 25 patients. Group 1 was operated with Phacoemulsification through limbal 2.8 mm incision with Foldable PCIOL implantation. & Manual small incision cataract surgery through 5.5 to 6.5 mm incision with sclerocorneal tunnel with PMMA PCIOL implantation. For all patients, macular OCT was performed during preoperative period & post-op 1st day,7th day, 1st month, 3rd month & 6th month. Statistical software SPSS, version 21.0 was used for statistical analysis. Results: In both PHACO & SICS group MCFT rose steadily during post-operative period and SICS group shows high rise during follow up.The MCFT shows a difference between PHACO & SICS group with the highest MCFT observed in 1st month follow up i.e., 231.6 micrometer (SD ±7.831) in PHACO group & 241.64 (SD ±7.35) micrometer in SICS group. The MCFT returned to near pre-op value by the 6th month. Conclusion: There is no effect of age and sex on macular thickness before and after in both PHACO and SICS groups. In SICS group significant macular thickness was observed as compared to PHACO group, so there should be more cautious to undertake SICS in those patients who are at risk of developing macular edema or who have a higher macular thickness as seen in diabetes patients. Keywords: Phacoemulsification (PHACO), small incision cataract surgery (SICS), Cystoid macular edema.


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.


2011 ◽  
Vol 21 (6) ◽  
pp. 748-753 ◽  
Author(s):  
Swati V. Zawar ◽  
Parikshit Gogate

Purpose. To assess safety and efficacy of temporal manual small incision cataract surgery (SICS) in context to visual outcome, astigmatism, and complications. Methods. This involved sclerocorneal tunnel, capsulotomy and hydrodissection. The incision was made with number 11 disposable surgical blade (costing Indian Rs. 2.50, $0.05). Nucleus extraction was done by phaco-sandwich method with the help of vectis and dialer. Posterior chamber intraocular lens implantation was done according to biometric findings. A record of intraoperative and postoperative complications was made. The final postoperative assessment of astigmatism was done with spectacle correction on the 45th day as per the refraction findings. Results. Two thousand eyes were operated by temporal, manual small incision sutureless technique. Uncorrected visual acuity was ≥6/18 in 1636 (81.7%) patients on the first postoperative day, in 1652 (82.6%) patients at 2 weeks, and in 1732 (88.6%) patients at 6 weeks. Best-corrected visual acuity (BCVA) ≥6/18 was achieved in 1868 (93.4%) patients at 6 weeks, with 46 (2.3%) having BCVA <6/60, 24 (1.2%) of whom had preexisting retinal pathology. At 6 weeks, 1876 (93.8%) eyes had with-the-rule and 134 (6.2%) against-the-rule astigmatism (mean 0.7±1.25 D). Iris prolapse was noted in 3 (0.15%), wound leak in 3 (0.15%), and transient corneal edema in 136 (6.8%) eyes. Average surgery time was 6 minutes. Conclusions. Temporal SICS with number 11 disposable surgical blade and nucleus delivery by phaco-sandwich method gave excellent outcome with minimal astigmatism and low complication rate at economic cost.


2016 ◽  
pp. 47 ◽  
Author(s):  
Eugene Appenteng Osae ◽  
Angela Ofeibea Amedo ◽  
Kwadwo Amoah ◽  
Nana Yaa Koomson ◽  
David Kumah

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