Outcomes of high volume cataract surgeries at a Lions Sight First Eye Hospital in Kenya

1970 ◽  
Vol 3 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Jyotee Trivedy
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Corneal Edema ◽  
High Volume ◽  
Posterior Capsule ◽  
Posterior Capsular Opacification ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Vitreous Loss ◽  
Posterior Capsule Tear

Background: High volume cataract surgery is practised in many eye centres. Objective: To investigate whether routine high volume cataract surgery can be performed without compromising the quality of surgery. Materials and methods: A retrospective interventional study was carried out at a high volume eye care centre including 368 subjects with cataract operated within 5 randomly selected theatres. Suture-less manual small incision cataract surgery (SICS) with PCIOL was performed in all except nine cases. Results: Of the total, 81.8 % of the patients achieved post-operative uncorrected visual acuity (UCVA) of 6/18 and better by the 4th week. Only 0.3 % had a posterior capsule tear without vitreous loss, 0.5 % posterior capsule tear with vitreous loss and 0.8 % had hyphema. Post-operative examination done at the camp site after Day 30 did not reveal anterior segment complications in any of the patients. Fifteen patients were found to have posterior capsular opacification and had the UCVA between 6/24 – 6/60. Only 12.9 % of the patients had first post operative day complications, which included transient corneal oedema (3.0 %) with less than 10 Descemet folds, transient corneal edema with > 10 Descemet folds (3.6 %), transient corneal edema (4.3 %), shallow anterior chamber (0.3 %) and others like iritis and peaked pupil. Multiple logistic regression analysis showed no significant association between risk factors like age, sex, laterality, pre-operative visual acuity, surgeon, time of surgery and post-operative UCVA. Conclusion: The study results show that high quality cataract surgery can be attained in a high volume setting. Key words: small-incision cataract surgery; surgical outcome; blindness DOI: 10.3126/nepjoph.v3i1.4276Nepal J Ophthalmol 2011;3(5):31-38

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 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 Perbandingan komplikasi antara fakoemulsifikasi dan manual Small-Incision Cataract Surgery (mSICS) pada operasi katarak massal: Sebuah penelitian kohort retrospektif

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Tri Winarti ◽  
Indra Tri Mahayana ◽  
Reny Setyowati ◽  
Suhardjo Pawiroranu
Keyword(s):  
Postoperative Complications ◽  
Cataract Surgery ◽  
High Volume ◽  
Posterior Capsule ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Department Of Ophthalmology ◽  
Posterior Capsule Rupture ◽  
Vitreous Prolapse ◽  
Capsule Rupture

Cataract is the most common cause of reversible blindness, and its prevalence have been increasing in the community depend on the age. Phacoemulsification and manual Small-Incision Cataract Surgery (mSICS) were the techniques of cataract surgery that was frequently used in high-volume cataract surgery setting. This study aimed to compare the complications between phacoemulsification and mSICS in high-volume cataract surgery. This research was a retrospective cohort study with the data taken from the medical record of high-volume cataract surgery organized by Community Ophthalmology Division, Department of Ophthalmology Universitas Gadjah Mada (UGM) from January 2018 to November 2018. Cataract surgery was performed by consultant ophthalmologists, general ophthalmologist, and senior ophthalmology resident for phacoemulsification and by senior ophthalmology resident and junior ophthalmology resident for mSICS. Intraoperative and postoperative complications (i.e. posterior capsule rupture, vitreous prolapse, aphakia, iridodialysis, endophthalmitis) until four weeks of follow up were compared in both techniques. There were 483 patients who had been operated, 188 (38.9%) patients underwent phacoemulsification and 295 (61.1%) patients underwent mSICS. Intraoperative and postoperative complications in phacoemulsification and mSICS performed by senior ophthalmology resident were no statistically significant different (p > 0.05). Nevertheles, there was statistically significant different in the complication of posterior capsule rupture and aphakia in phacoemulsification based on the level of surgeon’s skill (p < 0.05). Most of them performed by senior ophthalmology resident in 11 (35.5%) cases and 5 (16.1%) cases respectively. However, complications in mSICS were no significantly different based on the level of surgeon’s skill performed by senior ophthalmology resident and junior ophthalmology resident (p > 0.05). Complications in phacoemulsification and mSICS performed by senior ophthalmology resident with relatively similar in the level of surgeon’s skill were not significantly different. However, the complication of posterior capsule rupture and aphakia in phacoemulsification was significantly different based on the level of surgeon’s skill.

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 Outcome of cluster endophthalmitis in western plain region of Nepal

1970 ◽  
Vol 8 (1) ◽  
pp. 102-108 ◽  
Author(s):  
S Bajimaya ◽  
I Kansakar ◽  
BR Sharma ◽  
R Byanju
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Case Series ◽  
Visual Outcome ◽  
High Volume ◽  
Prednisolone Acetate ◽  
Sensitivity Testing ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Oral Ciprofloxacin

Background: Post-operative endophthalmitis remains one of the most visually devastating complications of cataract surgery. Cluster endophthalmitis is defined as five or more cases of endophthalmitis occurring on a particular day in a single operating room in one centre. Excessive inflammation, particularly in the early post-operative phase, should be regarded as infective endophthalmitis. Early diagnosis and immediate intervention in such case, lead to salvage of eye as well as better visual outcome. Objective: To find out the causative organisms and visual outcome after an outbreak of post-operative endophthalmitis in high volume cataract surgical centre. Materials and methods: Retrospective, interventional case series of 19 patients with acute post-operative endophthalmitis after manual small incision cataract surgery in a single day, underwent vitreous tap and received intravitreal Vancomycin, amikacin and Dexamethasone. Subconjunctival vancomycin was given at the end of the procedure. Vitreous samples were stained using Grams stain, Giemsa stain and KOH mount. Samples were sent to the hospital's microbiology laboratory for culture and sensitivity testing. All patients received intravenous ciprofloxacin for 3 days and oral ciprofloxacin for 7 days. Topical Prednisolone acetate, Ofloxacin, Gentamycin and atropine were given to all patients. Patients were followed up till 6 weeks. Results: 10 eyes had vitreous tap culture negative (52.6%) where as 9 eyes (47.4%) had bacterial culture growth. The culture reports showed 4 cases (21%) of Staphylococcus epidermidis, 3 cases (15.8%) of Staphylococcus aureus and 2 cases (10.5%) of mixed growth. 48 hours after the intervention, 15 patients improved clinically. On sixth week follow up, 7 eyes (37%) had visual acuity better than 6/18, 7 eyes had 6/18 to 6/60 and 5 eyes had visual acuity between 1/60 to 5/60. Conclusion: Intravitreal antibiotics and steroid, along with systemic ciprofloxacin and subconjunctival vancomycin has good visual outcome for post operative cluster endophthalmitis. Key words: Manual small incision cataract surgery; Cluster Endophthalmitis; Nepal DOI: 10.3126/kumj.v8i1.3232 Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29, 102-108

scholarly journals A novel nucleus extraction technique using a vectis in sutureless, manual, small-incision cataract surgery

2014 ◽  
Vol 6 (2) ◽  
pp. 140-144
Author(s):  
Yuan Zeng ◽  
Jiang-wen Deng ◽  
Jian-hua Gao
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Operating Time ◽  
Corneal Edema ◽  
Extraction Technique ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Posterior Capsule Rupture ◽  
Best Corrected Visual Acuity

Introduction: In manual, tunnel-incision cataract surgery, nucleus extraction has remained a crucial issue and a challenge. It is also the period when serious complications easily occur, especially for beginners and when the nucleus is large and dense.  Objectives: To report a modified vectis technique for nucleus extraction in sutureless, manual, small-incision cataract surgery (MSICS) to improve the safety and ease of performance.Materials and methods: A novel nucleus extraction technique using a vectis in MSICS is presented. After capsulorhexis and hydrodissection, the nucleus is moved into the anterior chamber and extracted by pulling with a Sinskey hook and pressuring on the scleral bed near the posterior wound margin with an irrigating vectis. Main outcome measures: The operating time for the whole surgery and nucleus extraction, best corrected visual acuity postoperatively and complications during and after operation were recorded. Results: In a series of 1,180 eyes, the operating time for the whole surgery and nucleus extraction were 8±3.4 minutes and 5.1±4.6 seconds respectively. Among all the eyes, 88.98 % achieved a best-corrected visual acuity of 5/10 or better two months postoperatively. The complications were posterior capsule rupture (4 eyes, 0.34 %) and transient corneal edema (12 eyes, 1.02 %). Neither vitreous loss nor dislocation of the nucleus into the vitreous was noted in the whole series of the surgery. Conclusions: We found that the “scleral bed” vectis technique for nucleus extraction improved the ease of performance, safety of MSICS, and did not require expensive instrumentation.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11708Nepal J Ophthalmol 2014; 6 (12): 140-144 

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 A COMPARISION OF POSTERIOR CAPSULAR OPACITY FORMATION UPTO 1 YEAR IN PATIENTS WITH SMALL INCISION CATARACT SURGERY WITH FOLDABLE INTRAOCULAR LENS AND PHACOEMULSIFICATION WITH THE SAME INTRAOCULAR LENS

2020 ◽  
pp. 173-176
Author(s):  
Kinjal Rathod ◽  
Kinjal Trivedi ◽  
Snehal Nayi ◽  
Somesh Aggarwal
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Nd:Yag Laser ◽  
Visual Outcome ◽  
Posterior Capsular Opacification ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Common Procedure ◽  
Age Related

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.

scholarly journals Visual outcome of conventional extracapsular cataract extraction with posterior chamber intraocular lens implantation versus manual small-incision cataract surgery

1970 ◽  
Vol 1 (1) ◽  
pp. 13-19 ◽  
Author(s):  
A Gurung ◽  
DB Karki ◽  
S Shrestha ◽  
AP Rijal
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Postoperative Period ◽  
Cataract Extraction ◽  
Posterior Chamber ◽  
P Value ◽  
Extracapsular Cataract Extraction ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Posterior Chamber Intraocular Lens

Background: An effective method for cataract surgery should be identified to combat cataract blindness. Aim: To study the surgical outcome of conventional extracapsular cataract extraction versus manual small-incision cataract surgery. Materials and methods: A randomized clinical trial was carried out including one hundred eyes (88 patients) which were divided into two groups using systematic randomization: groups of conventional extracapsular cataract extraction with posterior chamber intraocular lens (ECCE with PCIOL) implantation and manual small-incision cataract surgery (MSICS). The postoperative parameters/variables studied were the unaided and best-corrected visual acuity and astigmatism. Statistics: Epi info 2000 version statistical software was used for data analysis and calculation of relative risk, 95% CI and p value. The p value of less than 0.05 was considered as significant. Results: In the immediate postoperative period, unaided visual acuity of =/> 6/18 was achieved in 24 subjects in MSICS group versus 7 in ECCE with PCIOL group (RR=2.05, 95% CI=1.44 - 2.94, p = 0.0002), whereas the same at 6 - 8 weeks postoperatively was found in 28 and 22 subjects in those groups respectively (RR=1.27, 95% CI=0.86-1.89, p=0.23). The astigmatism of =/> 2 at 6 - 8 weeks was found in 35 and 17 subjects from the conventional and MSICS groups respectively ( R=2.28, 95% CI = 1.39-3.73, p=0.0002). Conclusion: Both MSICS and conventional ECCE with PCIOL are safe and effective techniques for treatment of cataract patients. A more rapid recovery of good vision can be achieved with MSICS than with conventional ECCE with PCIOL in the immediate postoperative period. Key words: ECCE; MSICS; visual acuity; astigmatism DOI: 10.3126/nepjoph.v1i1.3668 Nep J Oph 2009;1(1):13-19

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