scholarly journals A comparative study of combined small-incision cataract surgery with sutureless trabeculectomy versus trabeculectomy using W-shaped incision

1970 ◽  
Vol 3 (1) ◽  
pp. 13-18 ◽  
Author(s):  
AK Khurana ◽  
U Chawla ◽  
N Passi ◽  
A Jyoti ◽  
A Archana ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Posterior Chamber ◽  
Combined Surgery ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Group A ◽  
The Mean ◽  
Incision Technique ◽  
Group B

Introduction: Manual small-incision cataract surgery with trabeculectomy is now an acceptable option in the surgical management of combined cataract and glaucoma uncontrolled with maximum tolerated medical therapy. Objective: To compare the results and complications of combined manual small-incision cataract surgery (SICS) and posterior chamber intraocular lens (PCIOL) implantation with trabeculectomy by sutureless versus W-shaped incision technique. Materials and methods: The study included 30 eyes of 28 patients with senile cataract and primary open-angle glaucoma (POAG) who were randomly divided into two groups. The patients in Group A (n = 15) underwent SICS with sutureless trabeculectomy and those in Group B (n =15) underwent SICS with trabeculectomy using W-shaped incision with one suture. Post-operative evaluation was done at the first post-operative day and thereafter on follow-ups at 1 week, 2 weeks, 4 weeks and 8 weeks. Results: The mean preoperative and postoperative intraocular pressure (IOP) in Group A was 27.33 ± 3.35 mmHg and 16.13 ± 4.30 mmHg respectively and in Group B it was 29.46 ± 6.06 mmHg and 14.66 ± 2.69 mmHg respectively. The mean reduction in IOP after 8 weeks of follow-up in Group A was 12.52 ± 3.59 mmHg and that in Group B was 16.47 ± 3.79 mmHg (p <0.001). Besides this, the uncorrected visual acuity (UCVA) was better in Group B postoperatively with less surgically-induced against-the-rule (ATR) astigmatism. Conclusion: Combined SICS with trabeculectomy using W-shaped incision offers better prospective in terms of glaucoma control and visual performance than sutureless combined surgery. Key words: sutureless trabeculectomy; combined surgery; W-shaped trabeculectomyDOI: 10.3126/nepjoph.v3i1.4272Nepal J Ophthalmol 2011;3(5):13-18

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 A Comparative Study of 5.5mm Temporal Sclerocorneal Manual Small Incision Cataract Surgery Versus 5.5mm Temporal Clear Corneal Extended-incision Phacoemulsification with Implantation of a 5.25mm Rigid pmma Intraocular lens in the Bag

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Cataract Surgery ◽  
Controlled Study ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Corneal Incision ◽  
Small Incision ◽  
Clear Corneal Incision ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: Aim of the study is to Compare the astigmatism induced by a reduced temporal sclerocorneal tunnel incision manual small incision cataract surgery with an extended temporal clear corneal Phacoemulsification of similar width . Methods: A Prospective, randomised controlled study was carried out in 224 selected patients who were again divided into two groups - Group A (112 patients) and Group B (112 patients). Group A patients underwent temporal manual small incision cataract surgery with a 5.5 mm sclerocorneal incision and Group B underwent phacoemulsification by a 2.8 mm clear corneal temporal incision which was extended to 5.5 mm before IOL implantation. In both groups, a 5.25 mm rigid PMMA IOL was implanted in the bag. UCVA and BCVA of both group of patients was quantified and analyzed at 1 week and at 6 weeks Observation: It was seen that the mean surgically Induced astigmatism in group A (N=112) was 0.5625D , which was slightly lesser than that in Group B (N=112) which was 0.65D, although the p-value of 0.26 indicated that there was statistically no significant difference in visual outcomes between the two groups of patients. Here, a p-value of < 0.05 was considered statistically significant. Conclusion: In Skilled and Safe hands, refractive outcomes following performing a 5.5mm temporal sclerocorneal frown-incision manual small incision cataract surgery and a phacoemulsification procedure by a 2.8mm temporal clear corneal incision extended to 5.5mm for implanting a 5.25mm rigid PMMA IOL , are comparable.

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 Combined Cataract and Glaucoma Surgery: Trabeculectomy in Small Incision Cataract Surgery with Posterior Chamber Intra Ocular Lens (SISC with PCIOL) Implantation and its Success

2010 ◽  
Vol 23 (1) ◽  
pp. 15-17
Author(s):  
AKM Shahidur Rahman Tarafder ◽  
M Anwarul Kader
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Angle Closure ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
College Hospital ◽  
Small Incision ◽  
Counting Finger

Objective To asses the results are reducing and maintaining intraocular pressure of a patient having cataract with glaucoma, Performing Trabeculectomy (Filtration Surgery) and small incision cataract surgery (SICS) by the same wound & same sitting. Method and Materials This study was done at Rajshahi Medical College Hospital from July 2006 to June 2008. Forty (40) patients of age ranging from 45 to 65 years were selected randomly having cataract with glaucoma. Intraocular pressures (IOP) were 14mmHg to 17 mmHg preoperatively with anti-glaucoma medication. Visual acuity of all patients was perception of light to counting finger (CF) half meter to one meter. Thirty eight (38) patients (95%) had open angle glaucoma and two patients had chronic angle closure glaucoma. Informed consent was taken from all the patients. Trabeculectomy were done in the SICS wound. Side ports were made in every case. Delivery of nucleus, washing of cortical matter and introduction of PCIOL all are done under local anesthesia. Results :The patients were followed up 2 weeks, 4 weeks, 4 months and 6 months interval. All patients had IOP within normal limit (14-17mmHg) with medication before surgery cataract of all patients were total, fundus were invisible due to cataract. In the first post operative day (1st OPD) visual Acuity of thirty eight (38) patients (95%) were 6/24 to 6/18 and with pinhole 6/12, except 2 (two) patients (5%) among them 1 (one) (2.5%) having hyphaema. Hyphaema were relieved after 3 days by using Tab. Anaroxyl 3 times daily for 2 days and vitamin ‘C’ (250mg) daily for 15 days. After 6 weeks all patients had IOP 11mmHg to 14 mmHg without antiglaucoma medication and 39 (thirty nine) patients (95%) had achieved corrected vision 6/12 to 6/6. Except, 1 (one) (2.5%) had vision lowering counting finger 5 meter due to end stage glaucoma, who had cup disc ratio (C:D.9) 5 (five) patients (12.5%) developed polycystic bleb and rest diffuse functional bleb. Cup disc ration (C:D) of 39 (95%) was 0.4 to 0.8. no wound gap with iris proplase, thin bleb or fibrosed bleb with engorged overlying vessels were reported in any case. TAJ 2010; 23(1): 15-17

scholarly journals A study on the effect of topical lidocaine gel versus drops on surgeon’s comfort during manual small incision cataract surgery

2018 ◽  
Vol 7 (8) ◽  
pp. 1485
Author(s):  
Prakash Krishnan ◽  
Sancy Mary Sam ◽  
Sanitha Kuriachan ◽  
Nirmala Sethuraman
Keyword(s):  
P Value ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Prospective Comparison ◽  
Topical Lidocaine ◽  
Duration Of Surgery ◽  
Lidocaine Gel ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Cataract is a frequent surgical procedure performed worldwide. The study compared lidocaine 4% drops with 2% gel on surgeon’s comfort, need for supplemental anaesthesia and duration of surgery in patients who underwent manual small incision cataract surgery.Methods: This was a Prospective, Comparison study conducted at a Single centre by multiple surgeons. Patients enrolled for surgeries were divided into Group A: Lidocaine 4% drops 1ml was instilled in the conjunctival sac 5 minutes before surgery and Group B: Lidocaine 2% gel 2ml was applied. Endpoints evaluated were surgeon’s comfort, need for supplemental anesthesia and duration of surgery.Results: The mean duration of surgery for gel was 20±8 minutes as compared to 29±6 minutes with drops (p*- value<0.001). 26 (87%) patients in gel did not require any supplemental anesthesia as compared to 3 (10%) patients in drops. Peribulbar supplementation was required for 20 (67%) patients in drops as compared to 1 (3%) patient in gel (p*- value<0.001). 26 (87%) patients in gel were operated comfortably by the surgeon as compared to 2 (6%) patients in drops. Mild to Moderate discomfort was experienced by the surgeon in operating 27 (90%) patients in drops as compared to 3(10%) patients in gel (p*- value<0.001).Conclusions: The surgeons were more comfortable using gel with least requirement of supplemental anaesthesia and faster completion compared to drops.

scholarly journals A clinical study of corneal complications of cataract surgery

2020 ◽  
Vol 7 (10) ◽  
pp. 1550
Author(s):  
Anjana . ◽  
N. L. Padmaja ◽  
D. Sundararajan ◽  
K. Namitha Bhuvaneshwari ◽  
Manjunathan .
Keyword(s):  
Cataract Surgery ◽  
Corneal Edema ◽  
Cataract Extraction ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
College Hospital ◽  
Visual Rehabilitation ◽  
Small Incision ◽  
Group B

Background: In this study we investigate the incidence of corneal complications of extra capsular cataract extraction (ECCE) and manual small incision cataract surgery (SICS). We study the various etiological factors leading to these complications and also to highlight various prophylactic intra and post-operative measures to reduce these complications.Methods: Cataract surgery was conducted on 100 patients at Meenakshi Medical College Hospital and Research Institute. Patients were randomly divided into two groups. Group A of 50 patients were subjected to ECCE with posterior chamber intraocular lenses (PCIOL) and group B of 50 patients to small incision cataract surgery with PCIOL.Results: On the first post-operative day, 5 post-operative cases developed corneal edema (10%) in ECCE and 4 cases (8%) in SICS. Striate keratitis developed in 4 cases of ECCE (8%) and 3 SICS (6%). Nearly 62% patients who underwent ECCE accepted cylinder between 0.25-0.75 D while there were 52% cases in SICS.Conclusions: In this study we conclude that with various advances in cataract surgery the incidence of corneal complication have reduced and have helped in early visual rehabilitation and minimization of post-operative astigmatism by careful selection of incision type and location for MSICS.

Comparative Evaluation of Tear Film Parameters Following Cataract Surgery in Diabetic Patients.

2021 ◽  
Author(s):  
Sagarika Dash
Keyword(s):  
Cataract Surgery ◽  
Outcome Measures ◽  
Dry Eye ◽  
Tear Film ◽  
Diabetic Patients ◽  
Small Incision Cataract Surgery ◽  
Fluorescein Staining ◽  
Small Incision ◽  
Group A ◽  
Group B

Purpose: To compare the propensity of manual small incision and phacoemulsification cataract surgery in causing tear film dysfunction and dry eye syndrome in diabetic patients. Methods: Diabetic patients in group A underwent manual small Incision Cataract surgery whereas in group B underwent phacoemulsification with similar post-operative regimes. The primary outcome measures were the Ocular Surface Disease Index (OSDI), a Subjective questionnaire. The secondary outcome measures were the Subjective Dry Eye (DE) questionnaire, Corneal Fluorescein staining, Tear meniscus height, Schirmer’s II test, and Tear film break-up time. All parameters were measured pre and then postoperatively. Result: 126 patients were divided into group A (undergoing small incision cataract surgery) and group B (undergoing phacoemulsification). The OSDI and subjective DE scores continued to be worse for Group A until the first month after which they became similar to group B with no statistically significant difference (p-value of 0.726 and 0.347 respectively). The OSDI and subjective DES at 3 months were better in both groups as compared to baseline (p <0.0001). The objective tear film parameters (Schirmer’s, TBUT, TMH, and fluorescein staining scores) showed statistically significant changes from the baseline in both groups but the scores remained in the normal range clinically. Schirmer’s test scores were different between the two groups at three months (p=0.007) in SICS group being higher. Conclusion: Manual Small Incision Cataract Surgery (SICS) causes subjective dry eye symptoms more than phacoemulsification until 1 month of surgery in diabetic patients after which the subjective symptoms become similar to phacoemulsification at 3 months.

scholarly journals Modified Small Incision Cataract Surgery and Intraocular Lens Implantation in HIV Patients

2015 ◽  
Vol 7 ◽  
pp. OED.S31013 ◽  
Author(s):  
Kagmeni Giles ◽  
Christelle Domngang ◽  
Georges Nguefack-Tsague ◽  
Ebana Mvogo Come ◽  
Peter Wiedemann
Keyword(s):  
Cataract Surgery ◽  
Cataract Extraction ◽  
Posterior Chamber ◽  
Extracapsular Cataract Extraction ◽  
Continuous Variables ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Duration Of Surgery ◽  
Lens Implantation ◽  
The Mean

Aim To describe a surgical technique suitable for cataract surgery in regions with a high prevalence of HIV infection. Methods We reviewed the medical records of 20 consecutive AIDS patients with cataract who underwent modified small-incision cataract surgery (mSICS) with posterior chamber lens implantation. Classic extracapsular cataract extraction (ECCE) was compared to mSICS. The number of potentially risky steps for contamination during surgery and duration of surgery were analyzed. A risky step was defined as any time when the surgeon had to use a sharp instrument. Student's paired t-test was carried out to compare continuous variables, and P-values <0.05 were considered statistically significant. Results Twenty patients were included in the study, 13 males (65%) and seven females (35%). The mean age was 46.3 ± 13.6 years (range 22–70 years). The number of potentially risky steps for contamination was significantly higher in the classical ECCE than in mSICS ( P < 0.001). The mean duration of cataract surgery with mSICS was significantly shorter as well ( P < 0.001). Conclusion Conversion to mSICS is essential in order to reduce accidental injuries during cataract surgery in sub-Saharan countries. Sharp instruments should be passed through a neutral zone to ensure that the surgeon and nurse do not touch the same instrument at the same time.

Safety and Efficacy of Temporal Manual Small Incision Cataract Surgery in India

2011 ◽  
Vol 21 (6) ◽  
pp. 748-753 ◽  
Author(s):  
Swati V. Zawar ◽  
Parikshit Gogate
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Corneal Edema ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Safety And Efficacy ◽  
Excellent Outcome ◽  
Sutureless Technique ◽  
Small Incision ◽  
Sandwich Method

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.

scholarly journals Comparative study between conventional extra capsular cataract extraction versus manual small incision cataract surgery

2017 ◽  
Vol 5 (3) ◽  
pp. 996 ◽  
Author(s):  
Gannaram Laxmiprasad ◽  
Chhaya Shori ◽  
Rakesh Shori ◽  
Ashalatha Alli
Keyword(s):  
Cataract Surgery ◽  
Tertiary Care ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Visual Rehabilitation ◽  
Surgically Induced Astigmatism ◽  
Small Incision ◽  
Significant Difference ◽  
Induced Astigmatism ◽  
Surgically Induced

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.

Sign in / Sign up

Export Citation Format

Share Document