Astigmatic Changes in Sutureless Small Incision Cataract Surgery

2021 ◽  
Vol 6 (1) ◽  
pp. 1280-1284
Author(s):  
Roshan Dev Yadav ◽  
Kabindra Bajracharya ◽  
Neelam Shrestha ◽  
Kriti Joshi ◽  
Aman Kumar Gupta
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Uncorrected Visual Acuity ◽  
Induced Astigmatism ◽  
Version 2.0 ◽  
A Prospective Study ◽  
Early Healing ◽  
Chevron Incision

Introduction: Cataract is the main cause of bilateral blindness in Nepal. Surgery is the accepted treatment option for cataract with Small incision Cataract Surgery (SICS) and Phacoemusification being the common procedures being performed with comparable results. Corneal astigmatism has been a byproduct of cataract surgery since the first limbal incision was made with improved techniques. Self-sealing scleral pocket incisions are stable and provides early healing, faster visual restoration and more importantly superior astigmatism control. A variety of scleral incisions are being used in manual SICS, with the aim of keeping the post-operative astigmatism to a minimum. Despite having many techniques of scleral incision, there have been only few studies which compares surgical induced astigmatism (SIA) between them Objective: To determine surgical induced astigmatism following frown, chevron and straight incision forms in suture-less small incision cataract surgery(SICS). Methodology: A prospective study was done on a total of 120 patients aged 40years and above with senile cataract. The patients were randomly divided into three groups where each group received specific incision- Straight, Frown and Chevron. SICS with intraocular lens (IOL) implantation was performed. The patients were compared on 2 weeks and 6 weeks post operatively for uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and keratometric reading. Surgical induced astigmatism (SIA) was calculated using the SIA calculator version 2.0. The study was analysed using SPSS version 20.0. Results: At 6 weeks UCVA of 6/18-6/6 was attained by 63.41%, 78.94% and 84.61% of patients in group straight, frown and chevron. However about 97% of patients attained BCVA of 6/18-6/6 in all three groups. Mean SIA was least in Chevron group (0.30 D ± 0.16) and was most in the straight group (1.22 D ±0.36) which was statistically significant. Conclusion: Chevron incision induces the least astigmatism compared to frown and straight incision.

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 Comparison of surgical and visual outcomes following capsulotomy using the envelope and continuous curvilinear capsulorhexis technique in manual small incision cataract surgery

2016 ◽  
Vol 12 (1) ◽  
pp. 10-13
Author(s):  
Sanjib Kr Chaudhary ◽  
Shailesh Mani Pokhrel ◽  
Manoj Sharma ◽  
Badri Prasad Badhu ◽  
Bhuwan Govinda Shrestha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Posterior Capsular Opacification ◽  
Surgical Time ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Uncorrected Visual Acuity ◽  
Group A ◽  
Group B

Background & Objectives: Capsulotomy is one of the important step in cataract surgery which can affect the surgical outcomes. The aim of the study was to compare the outcomes of envelope and continuous curvilinear capsulorhexis technique in manual small incision cataract surgery (MSICS). Materials & Methods: A total of 72 eyes of 72 patients undergoing MSICS were studied. The patients were equally divided into two groups i.e. 36 patients each in envelope capsulotomy (Group A) and continuous curvilinear capsulotomy (CCC) group (Group B).Results: Mean surgical time (±SD) in Group A was 355.83 sec ±37.79 sec and in Group B was 375 sec ±31.214 (p=0.02). Uncorrected visual acuity on postoperative day 1 was 6/9 or better in 50% (18) cases in Group A and in 36% (13) cases in Group B (p=0.28). Best corrected visual acuity (BCVA) on post-operative week 12 was 6/9 or better in 30.6% (n=11) cases in Group A and in 36% (n=13) cases in Group B (p=0.43). On 12th week postoperatively, Grade 2 posterior capsular opacification (PCO) was seen in 30.6 % (n=11) cases of Group A and in 16.6 % (n=6) cases of Group B (p=0.17). Conclusion: CCC technique can be considered superior to envelope technique for long term visual rehabilitation.JCMS Nepal. 2016;12(1):10-13.

scholarly journals A comparative study of sclero-corneal and clear corneal tunnel incision in manual small-incision cataract surgery

1970 ◽  
Vol 3 (1) ◽  
pp. 19-22
Author(s):  
S Archana ◽  
AK Khurana ◽  
U Chawla
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Surgically Induced Astigmatism ◽  
Small Incision ◽  
Group A ◽  
Induced Astigmatism ◽  
Group B ◽  
Surgically Induced

Background: Cataract surgery techniques have improved a lot over the years from couching to the latest micro-incision cataract surgery. Objectives: To compare the temporal sclero-corneal and clear corneal tunnel incisions in patients undergoing manual small-incision cataract surgery (SICS) with respect to the surgically-induced astigmatism. Materials and methods: The present study included 60 patients who underwent manual SICS with posterior chamber intraocular lens implantation. Group A comprised of 30 patients, selected randomly, who underwent sutureless manual SICS through 6 mm curvilinear clear corneal tunnel incision made temporally and Group B comprised of 30 patients, selected randomly, who underwent sutureless manual SICS through 6 mm straight sclero-corneal tunnel made temporally. The patients were assessed at 1 week, 2 weeks, 1 month and 2 months post-operatively and visual acuity and keratometry findings were recorded. The amount of surgically induced astigmatism was calculated using Holladay’s formula. Statistics: Numerical data were compared between the two groups using unpaired Student’s t-test. The p value of < 0.50 was considered significant. Results: The mean induced astigmatism in Group A was 2.69 ± 0.84 D at 1 week, 2.31 ± 0.77 D at 2 weeks; 2.03 ± 0.82 D at 4 weeks and 1.98 ± 0.54 D at 8 weeks post-operatively. In group B, it was 1.85 ± 0.62 D, 1.56 ± 0.54 D, 1.35 ± 0.49 D and 1.34 ±0.45 D at 1 week, 2 weeks, 4 weeks and 8 weeks postoperatively. Uncorrected visual acuity (UCVA) of 20/ 20 was seen in 20 % of patients in group A and in 40 % in group B at 8 weeks postoperatively. Conclusion: Surgically-induced astigmatism is significantly higher in clear corneal manual SICS than in sclero-corneal. Our study confirmed the safety and improvement in visual acuity after small-incision cataract surgery using sclero-corneal tunnel incision. Key words: astigmatism; sclero-corneal; clear corneal tunnel; extra-capsular cataract surgery; small incision cataract surgery DOI: 10.3126/nepjoph.v3i1.4273Nepal J Ophthalmol 2011;3(5):19-22

scholarly journals OUTCOME OF SMALL-INCISION CATARACT SURGERY AND PHACOEMULSIFICATION IN TERM OF VISUAL ACUITY AND POST OPERATIVE ASTIGMATISM.

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr Rishi Gupta
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Tertiary Care ◽  
Care Hospital ◽  
Small Incision Cataract Surgery ◽  
Visual Rehabilitation ◽  
Small Incision ◽  
Uncorrected Visual Acuity ◽  
Better Than

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

scholarly journals Comparison of Nonphaco small incision Cataract Surgery with Conventional Method: An Observational Study

2019 ◽  
Vol 5 (2) ◽  
pp. 185-190
Author(s):  
Shamima Sultana ◽  
AQM Omar Sharif ◽  
Nazneen Begum ◽  
Salma Parveen ◽  
Wahida Begum ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Conventional Method ◽  
Perioperative Complications ◽  
Age Distribution ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Uncorrected Visual Acuity ◽  
Cataract Patients

Background: Cataract surgery is very important for the correction of visual acuity among the patients. Objective: The purpose of the present study was to assess the uncorrected visual acuity in small incision cataract surgery (SICS) with PCIOL than conventional method of ECCE with PCIOL implantation. Methodology: This cross-sectional study was conducted at National Institute of Ophthalmology, Dhaka, Bangladesh from January 1999 to December 2000 for a period of two (02) years. Patients with senile cataract were selected for study. A comparative study of changes in postoperative visual outcome and refractive status during post-operative follow up period up to 2 months were observed and documented between two groups of patients, one with suture less nonphaco SICS with PCIOL another with conventional ECCE with PCIOL. All the cataract surgery were done by the same surgeon, and in same place. All the patients were examined carefully both pre and post-operatively. For the purpose of recording, a proforma was made that includes particulars of the patient, complete history, general examination, ocular examination, relevant investigations, operation note, perioperative complications, post-operative follow-up, pre and post-operative visual acuity with keratometric reading. Result: A total of 60 eyes of cataract patients were included in the study of which 30 eyes of cataract patients were randomly selected for suture less nonphaco SICS with PCIOL and 30 eyes of cataract patients were for conventional ECCE with PCIOL.Mean age distribution (58.83±5.55 and 58.77±6.56) was similar in both groups. The unaided vision in both SICS & ECCE group at different postoperative intervals was reported. At day7 and month 1 postoperatively the result appears highly significant between the two groups. At day 1 and month 2 also shows the significant result between the 2 groups. The best corrected visual acuity in SICS and ECCE group at different postoperative intervals was measured. At day 7 and month 1 postoperatively the result appears highly significant between the two groups. At day 1 and month 2 also shows the significant result between the 2 groups.In SICS group out of 30 patients, 7(23.3%) cases acquired unaided vision 6/9 at day 1, 10(33.3%) patients at day 7,14(46.6%)patients at month 1 and 15(49.9%) patients at month 2. On the other hand in ECCE group no patient was found with vision ≥6/9 at day 1 and only one patient with vision ≥6/9 at day 7.At month 1 there were 5(16.6%) patients, and at month 2 there were 9(29.9%)patients with vision ≥6/9. Nearly 50.0% patients of SICS group achieve unaided vision of ≥6/9 within the follow up period of 02 months. Conclusion: In conclusion Uncorrected visual acuity in SICS cases were better than that of ECCE cases with sutures. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 185-190

scholarly journals Comparison of Visual Acuity between Post Small Incision Cataract Surgery and Phacoemulsification in Sanjiwani Hospital

2021 ◽  
Vol 3 (6) ◽  
pp. 101-104
Author(s):  
P. A. A. S. Surya ◽  
N. N. Sunariasih
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Retrospective Cohort ◽  
Total Population ◽  
Surgical Techniques ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Uncorrected Visual Acuity ◽  
The World ◽  
Cataract Patients

Cataracts are the second most common cause of blindness in the world at 33%. The incidence of cataracts is 0.1% of the total population, so the number of new cataract cases in Indonesia is estimated at 250,000 per year. This study aims to compare the visual acuity of post cataract surgery patients with Small Incision Cataract Surgery and Phacoemulsification techniques at Sanjiwani Hospital, Gianyar. This study was a retrospective cohort at Ophthalmologist’s Outpatient Departement of Sanjiwani Hospital, Gianyar, Bali. The sample of this study was 60 patients with 84 eyes with senile cataract. The surgical techniques performed were Small Incision Cataract Surgery (53.6%) and Phacoemulsification (46.4%). After that, an Uncorrected Visual Acuity (UCVA) examination was carried out on day 1 and day 42. The result were cataract patients at Sanjiwani Hospital, Gianyar aged 60-65 years who were male. Comparison of visual acuity after Small Incision Cataract Surgery and Phacoemulsification had the same results. On day 1 and day 42, there was no different uncorrected visual acuity result between Small Incision Cataract Surgery and Phacoemulsification statistically.

scholarly journals Comparison of visual outcomes in patients undergoing small incision cataract surgery versus phacoemulsification at Divisional Headquarters Hospital, New Mirpur, Azad Kashmir.

2019 ◽  
Vol 26 (08) ◽  
pp. 1365-1369 ◽  
Author(s):  
Khawaja Abdul Hamid ◽  
Shaista Habibullah
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Cataract Extraction ◽  
Extracapsular Cataract Extraction ◽  
Small Incision Cataract Surgery ◽  
Visual Outcomes ◽  
Small Incision ◽  
Department Of Ophthalmology ◽  
Significant Difference ◽  
Uncorrected Visual Acuity

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.

scholarly journals Randomized Controlled Trial of varied incision sites in Manual Small Incision Cataract Surgery done in a Medical College Hospital in Kancheepuram District, Tamil Nadu, India

2020 ◽  
Vol 5 (8) ◽  
pp. 237-242
Author(s):  
Dr. J. Samuel Cornelius Gnanadurai ◽  
◽  
Dr. S. Vimala Karunanidhi ◽  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Tamil Nadu ◽  
Controlled Trial ◽  
Age Group ◽  
Small Incision Cataract Surgery ◽  
Surgically Induced Astigmatism ◽  
Small Incision ◽  
Induced Astigmatism ◽  
Surgically Induced

Aim: To compare visual outcome, postoperative surgically induced astigmatism (SIA), andpostoperative complications of superior and temporal scleral incision in manual small incisioncataract surgery (MSICS). Materials and Methods: A Prospective Randomized, parallel-group,active-controlled Trial Study of 80 cases of senile/pre-senile cataract. 40 cases were randomlyassigned (computer-generated randomization) to superior incision and 40 cases to the temporalincision. Results: The majority of patients (38 patients- 47.5%) were in the age group of 56-65years. The next common age group was 66-75 years(31 patients-38.75%). In the superior MSICSgroup, the majority of patients (28 patients-70%) had a moderate post-operative unaided visualacuity of 6/18-6/12. In the temporal MSICS group, majority of patients(33patients-82.5%) had agood post-operative unaided visual acuity of 6/9-6/6. The mean surgically induced astigmatism(SIA)in the superior MSICS group was 1.12 and in the temporal MSICS group was 0.45 with a differenceof 0.67. The SIA values were analyzed using the unpaired T-test which showed a value of 9.967which was statistically significant(P value of 0.0001). Conclusion: This study has shown that thetemporal approach for Manual small incision cataract surgery(MSICS) has less postoperativeastigmatism and better postoperative unaided visual acuity compared to the superior approach.

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