scholarly journals COMPARISON OF POSTOPERATIVE CORNEAL ASTIGMATISM IN PHACOEMULSIFICATION AND MANUAL SMALL INCISION CATARACT SURGERY

Author(s):  
NAYANTARA NAIR ◽  
DIVYA N. ◽  
V. PANIMALAR ◽  
A. VEERAMANI ◽  
BINDU BHASKARAN

Objective: Globally a significant proportion of treatable blindness is caused by cataract, especially in India and southeast Asia. Treatment of cataract is surgical correction with intraocular lens implantation. The main drawback of surgical correction is induction of postoperative astigmatism in patients. The aim of this study was to compare the degree of astigmatism in manual small incision cataract surgery and phacoemulsification 3 mo postoperatively Methods: The study was a retrospective case study on postoperative corneal astigmatism after cataract surgery. It was conducted in a tertiary care hospital in Thandalam, Tamil Nadu. A total of 100 patients were selected and divided into two groups, group A (=50) underwent phacoemulsification and group B (=50) underwent manual small incision cataract surgery. Preoperative astigmatic status of the patients was noted from patient records. Both groups were evaluated 3 mo postoperatively using automated keratometry. The data collected was analyzed using Microsoft Excel Independent T test, p<0.05 was considered statistically significant. Power of the study was 80% with an alpha error of 5%. Results: Mean postoperative astigmatism at 3 mo was 0.91±0.255D and 0.34±0.110D due to manual small incision cataract surgery and phacoemulsification, respectively. Conclusion: Postoperative astigmatism was greater in manual small incision cataract surgery than phacoemulsification. Improvement in preoperative astigmatism was seen in patients who underwent superotemporal incision phacoemulsification

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.


Author(s):  
Dr Rishi Gupta

Objective: To compare the outcome of Small-incision cataract surgery and Phacoemulsification in term of visual acuity and post operative astigmatism Methods: A retrospective study carried out on 100 eyes of 100 patients from January 2017 to June 2017 at tertiary care hospital. All patients with senile cataract (up to grade IV) operated with SICS or Phacoemulsification were included. Records on all examinations including visual acuity, refraction, biometry, slit lamp biomicroscopy and fundoscopy from the period before surgery up to 6 weeks post-operatively were obtained. Result: The present study reports clinical outcomes of Small-incision cataract surgery and Phacoemulsification up to 6 weeks. Out of 50 patients 34 (68%) patients in the phacoemulsification group and 31 (62.%) of 50 patients in the small-incision group had uncorrected visual acuity better than or equal to 6/18 at 1 week. 41(82%) patients of the phacoemulsification group and 35 (70.%) patients of the small-incision group were better than or equal to 6/18 at the 6-week follow-up for presenting visual activity. Visual acuity improved to 6/18 with best correction in 49 patients (98 %) and 48 (96%) patients respectively. The mode of astigmatism was 0.5 diopters (D) for the phacoemulsification group and 1.5 D for the small-incision group, and the average astigmatism was 1.0 D and 1.3 D, respectively. Conclusions: Both the phacoemulsification and the small-incision techniques are safe and effective for visual rehabilitation of cataract patients, although phacoemulsification gives better uncorrected visual acuity and faster recovery


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

Author(s):  
Gannaram Laxmiprasad ◽  
Chhaya Shori ◽  
Rakesh Shori ◽  
Ashalatha Alli

Background: Recent reports indicate that both manual small incision cataract surgery and extra capsular cataract excision surgery with posterior chamber intraocular lens implantation are safe and effective for treatment of cataract surgery, however, manual small incision cataract surgery gives better uncorrected vision. Objectives of the study were to compare intraoperative and postoperative complications, to compare induced astigmatism and to compare the visual rehabilitation.Methods: This is a prospective study of 100 consecutive patients assigned to undergo conventional extra capsular cataract excision surgery (50 cases) and manual small incision cataract surgery (50 cases). Study was done for a period of two years at a tertiary care referral hospital. Institutional Ethics Committee permission was taken. Also the informed consent was obtained from each patient.Results: In conventional ECCE, the most common surgically induced astigmatism was WTR in 73.4% of cases with mean of 2.79 D±1.3 on first day. 70% of cases with mean 2.1 D±1.28 and 64% of cases with mean of 1.86 D±1.14 at six weeks. ATR was common in MSICS group, 83.67% of cases with mean of 1.5 D±0.72 on first day, 86% of cases with mean of 1.03 D±0.6 at one week and 88% of cases with mean of 1.27 D±0.81 at six weeks. The induced astigmatism was less in MSICS group compared to ECCE group at first day but after six weeks there was no much significant difference found. Early visual recovery was better in MSICS groupConclusions: MSICS has definitive advantages over conventional ECCE in terms of early visual rehabilitation, minimal surgically induced astigmatism; no suture related complications and reduced surgical time.


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