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 Visual Outcome of Phacoemulsification Versus Small Incision Cataract Surgery

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Narain Das ◽  
Asma Shams Shaikh ◽  
Jai Kumar ◽  
Beenish Khan ◽  
Nasir Bhatti
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Small Incision Cataract Surgery ◽  
Visual Rehabilitation ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Group I ◽  
Group Ii ◽  
Best Corrected Visual Acuity ◽  
Group 1

Purpose:  To determine visual rehabilitation of Phacoemulsification in comparison to small incision cataract surgery after implantation of rigid intraocular lens. Study Design:  Quasi Experimental Study. Place and Duration of Study:  Shaheed Mohtarma Benazir Bhutto Medical College Lyari and Sindh Government Lyari General Hospital, Karachi, from July 2018 to December 2019. Methods:  Patients with 35 – 70 years age and diagnosed with senile cataracts and visual acuity of <6/36were included. Patients having any corneal disease, intra-ocular pressure > 22 mmHg, high ametropia, any other eye disease were excluded. Patients were divided into two groups of 80 patients each. Group I underwent Phaco-emulsification and group II had Small incision cataract surgery. For data analysis, SPSS version 20.0 was used. Frequency and percentages were calculated for qualitative data and quantitative data was presented as mean and standard deviation. Results:  In a total of 160 patients operated of cataract, male to female ratio was 1:1. The range of astigmatism after 6 months in the group I was between 0.5 – 1.00 D while in the group II, it was between 0.75 – 1.75 D. Uncorrected visual acuity and best corrected visual acuity of 6/18 or better was seen in 90 and 97% group 1 while it was 85% and 95% in group II patients respectively at sixth month. Conclusion:  No significant difference was seen in uncorrected and best corrected visual acuity between the two groups. Time of surgery was lesser group 2 and Astigmatism was lesser in group 1. Key Words:  Phaco-emulsification, Small Incision Cataract Surgery, Visual Rehabilitation.

scholarly journals Modified manual small incision cataract surgery technique for phacoemulsification-trained surgeons

2020 ◽  
Vol 12 ◽  
pp. 251584142097737
Author(s):  
Darren S. J. Ting ◽  
Daniel Chua ◽  
Khin Oo May ◽  
Mya Aung ◽  
Ashish Kumar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Visual Outcome ◽  
Modified Technique ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Capsular Rupture ◽  
Best Corrected Visual Acuity

Purpose: To present the technique and outcomes of a modified manual small incision cataract surgery designed for the phacoemulsification surgeons who are learning to perform manual small incision cataract surgery. Methods: This was a retrospective, single-centred, comparative study. We included all the patients who underwent the modified manual small incision cataract surgery for visually significant cataract at Singapore National Eye Centre. All surgeries were performed by either a senior phaco-trained surgeon (M.A.) who had performed more than 500 manual small incision cataract surgery or a junior phaco-trained surgeon (D.C.) who had performed around 500 phacoemulsification but never performed any manual small incision cataract surgery. The main modification of this technique lies in the creation of an additional phaco-like main wound at 90° to the scleral tunnel wound, with most surgical steps performed through this additional wound. The outcomes were analysed and compared between the senior and junior surgeons. The main outcome measures were visual outcome and major intraoperative complications such as posterior capsular rupture and zonular dialysis. Results: A total of 132 cases were included; 102 (77.3%) and 30 (22.7%) cases were performed by the senior and junior surgeons, respectively. Pre-operatively, 85.6% eyes had best-corrected visual acuity of counting fingers or worse. Postoperatively, the visual outcome at 1 month was similar between the senior and junior surgeons, with 68.7% eyes achieving a best-corrected visual acuity of ⩾6/12 ( p = 0.17). No posterior capsular rupture, zonular dialysis or endophthalmitis was observed during the study period. Conclusions: This modified technique may serve as a useful transition technique for the phaco-trained surgeons to develop skills in manual small incision cataract surgery, with demonstrable good visual outcome and safety.

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 Small Incision Cataract Surgery (SICS) with Posterior Chamber Intraocular Lens (PCIOL) Implantation is the Preferred Method of Community-Based Cataract Surgery: Study of 100 Cases

1970 ◽  
Vol 22 (1) ◽  
pp. 132-135
Author(s):  
AKM Shahidur Rahman Tarafder ◽  
M Anwarul Kader ◽  
SM Rezaul Karim
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Extracapsular Cataract Extraction ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Department Of Ophthalmology ◽  
Posterior Chamber Intraocular Lens

To study "small incision cataract surgery (SICS)" for the rehabilitation of cataract visually impaired and blind patients, a retrospective study of 100 cases of cataract patients with small incision cataract surgery (SICS) with posterior chamber intraocular lens (PCIOL) implantation were done at Rajshahi Medical College Hospital. All cases were selected having corrected visual acuity less than 6/60 who were admitted at the Department of Ophthalmology for cataract surgery from March, 2006 to February, 2008. Age group of the patient range from 40 to 85 years. Age related senile cataract were selected any complicated cataract was excluded from the study. All these patients underwent SICS with 5.5 mm optic polymethylmethacrylate (PMMA) non-foldable posterior chamber intraocular lens (PCIOL) were implanted by irrigation vectis. Intra operative complication were present in 8% cases among them 3 cases (3%) required to conversion to Conventional Extracapsular Cataract Extraction (ECCE). 2 cases (2%) had small posterior capsular rent (PCR), 1 case (1%) irido dialysis & 2 cases (2%) hyphaema occurred. Postoperative complications were found in 38 cases (38%) among them transient corneal oedema occurred in 18 cases (18%) iritis occurred in 13 cases (13%), decentering of intraocular lens (IOL) occurred in 2 cases, corrected visual acuity after 6 weeks of operation were 6/12 or better in 97 cases (97% cases achieved functional vision). Induced astigmatism ± 0.50 D to ± 1.00 D occurred in 94 cases (94%) and ± 1.500 to 2.50D in 6 cases (6%). So, SICS may be the choice of surgery in respect of visual outcome with the limited facilities and surgeons. DOI: 10.3329/taj.v22i1.5037 TAJ 2009; 22(1): 132-135

scholarly journals Changes in macular thickness post uncomplicated MSICS & phacoemulsification surgery

2022 ◽  
Vol 7 (4) ◽  
pp. 619-623
Author(s):  
Kartika Anand ◽  
Ashutosh Dokania
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Thickness ◽  
Posterior Chamber ◽  
Prospective Clinical Study ◽  
Small Incision Cataract Surgery ◽  
Corrected Visual Acuity ◽  
Clinically Significant ◽  
Clinically Significant Macular Oedema ◽  
Best Corrected Visual Acuity

To evaluate changes in macular thickness via-a-vis visual acuity post uncomplicated manual small incision cataract surgery (MSICS) & phacoemulsification surgery Prospective clinical study on 160 patients of uncomplicated immature senile cataract, aged 40-70yrs, patients were randomised into two groups, MSICS & phacoemulsification, by simple 1:1 randomization, who underwent uncomplicated cataract surgery with posterior chamber intraocular lens (PCIOL). Post-operatively, the patients were evaluated for best corrected visual acuity (BCVA) and changes in macular thickness by optical coherence tomography (OCT) at post-op Day 1, 7, 21, 48, and 12 weeks. Paired t-test was used for comparison across follow up. : At 12 weeks post-operative, mean logMAR BCVA was 0.01±0.02 for MSICS group and 0±0.02 for Phacoemulsification group. Macular thickness was not statistically significant (p=0.342) between MSICS group (219.19±17.88µm) and Phacoemlusification group (215.61±16.21µm), at the end of 12 weeks post-operative. Clinically significant macular oedema was not diagnosed in any of the patients at the follow-ups.: Both procedures achieved good post-operative Best Corrected visual acuity without significant differences in BCVA between both the groups at the end of 12 weeks.

scholarly journals Improving the Outcomes of Modified Manual Small Incision Cataract Surgery Using Clinical Audit

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Muhammad Ifraheem Khan ◽  
Saba Ali Arif ◽  
Muhammad Raja ◽  
Sheikh Ijaz ◽  
Muhammad Saeed Khan
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Clinical Audit ◽  
Cataract Extraction ◽  
University Hospital ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Good Technique ◽  
Capsular Rupture

Purpose:  To use clinical audit in improving the outcomes of manual small incision cataract surgery technique Study Design:  Clinical audit. Place and Duration:  Layton Rehmatullah Benevolent Trust Eye hospital Karachi, from September 2019 to December 2019. Methods:  Two hundred patients who had undergone Manual Small Incision Cataract surgery were selected. Cases with traumatic cataract, weak zonules, pseudoexfoliation, and more than 1 diopter difference in keratometric readings, corneal and retinal pathologies were excluded. Surgical complications and visual outcomes were recorded on the 7th postoperative day. Refractive data was recorded from subjective refraction. Data was analyzed by University Hospital Bristol formula. Standards were set using international literature. Deficiencies were noted and technique was modified to improve the outcome. The audit was repeated after 2 months to see whether modifications had improved the outcome. Results:  In the first audit, posterior capsular rupture rate was 1%, corrected visual acuity of 6/12 or better was achieved in 85.36% and surgically induced cylinder of less than 2 DC was achieved in 75.60% of the patients. In the second audit all standards were achieved. Posterior capsular rupture did not occur. Corrected visual acuity of 6/12 or better was achieved in 90.50% and induced cylinder of less than 2 DC was achieved in 87.05% of the patients. Conclusion:  Clinical audit of the surgical procedures is a good technique in improving the outcomes of manual small incision cataract surgery. Key Words:  Cataract extraction, clinical audit, posterior capsular rupture, astigmatism, visual acuity.

scholarly journals Cataract surgery in camp patients: a study on visual outcomes

1970 ◽  
Vol 3 (2) ◽  
pp. 159-164
Author(s):  
SG Pai ◽  
SJ Kamath ◽  
V Kedia ◽  
K Shruthi ◽  
A Pai
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Evaluation Team ◽  
Visual Outcomes ◽  
Corrected Visual Acuity ◽  
Operative Complications ◽  
Best Corrected Visual Acuity

Aim: To assess the complications and visual outcomes associated with cataract surgery in camp patients operated at a tertiary centre. Materials and methods: In a retrospective study, 206 outreach camp patients had undergone cataract surgeries with posterior chamber intraocular lens implantation under peribulbar anesthesia over a period of 6 months. Post-operative complications on Day 1 were graded as per Oxford Cataract Treatment and Evaluation Team (OCTET) definitions. One month postoperative complications, best corrected visual acuity and refractive errors were assessed. Results: 206 eyes underwent cataract extraction with PCIOL implantation. Small incision cataract surgery (SICS) was the commonest method (78.6%) used. The most common first post-operative day complication was mild iridocyclitis (26.2%). The complications were based on OCTET definitions, and showed that 33 % had Grade I and 3.4 % had Grade II complications. The major post-operative complication after 4 weeks of surgery was posterior capsular opacity. 89.8 % of the eyes had a 4 week-post-operative best corrected visual acuity of e” 6/24. The commonest refractive error was myopia with against the rule astigmatism, seen in 86 out of 150 cases. Conclusion: High quality cataract surgery with a low rate of intra-operative complications and good visual outcome can be attained in camp patients operated in the base hospitals, thus justifying more similar screening camps to clear the vast cataract backlog. Key words: cataract surgery, eye camp, visual outcomes DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5270 Nepal J Ophthalmol 2011; 3(2): 159-164

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

scholarly journals Dry eye syndrome and cataract surgery

2019 ◽  
Vol 72 (3-4) ◽  
pp. 105-109
Author(s):  
Stefan Brunet ◽  
Vladimir Canadanovic ◽  
Nikola Babic ◽  
Aleksandar Miljkovic ◽  
Sandra Jovanovic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Dry Eye ◽  
Dry Eye Syndrome ◽  
Schirmer Test ◽  
Corrected Visual Acuity ◽  
Body Sensation ◽  
Eye Symptoms ◽  
Best Corrected Visual Acuity ◽  
Dry Eye Symptoms

Introduction. Dry eye syndrome has become a common problem after ocular surgeries with a significant impact on the quality of life. Many patients, who have undergone cataract surgery, postop?eratively developed dry eye symptoms. Dry eye syndrome is one of the risk factors associated with cataract surgery. Material and Methods. The prospective study included 80 patients. We recorded the self-reported dry eye symptoms, the values of Schirmer test, tear breakup time, and best corrected visual acuity preoperatively, as well as 7 days and 1 month after the surgery. Results. A total of 80 patients were included in the study, 45 (56.2%) females and 35 (43.8%) males. The mean age of patients was 61.5 years (SD ? 6.2, range 57 - 70 years). The best corrected visual acuity at the time of surgery was 0.4 or less in 70 patients (87.5%). Most patients reported a significant improvement in visual acuity after surgery; 68 (85%) eyes achieved a best corrected visual acuity of 0.5 or higher (median 0.7; range 0.5 - 1.0). The mean tear breaking time in cata?ract patients before surgery was 12.4 sec, 7 days after the surgery it was 8.2 sec (p < 0.05) and 1 moth after the surgery 11.1 sec. The majority of patients had mild (47.5%) and moderate (33.75%) Schirmer test values. Dry eye with wetting < 5 mm after 5 minutes was found in 16.2% of patients before cataract surgery; 7 days after the surgery (p < 0.05) it was found in 23.75% of patients and one month after surgery 11.1 sec. A foreign body sensation and watery eye were the most reported symptoms before cataract surgery. Seven days after the surgery foreign body sensation was present in 48.75% and watery eyes in 40% of patients. Conclusion. Significant increase in dry eye symptoms after cataract surgery was found with increasing age. Self reported dry eye problems are more common in patients with lower Schirmer test and best corrected visual acu?ity values before cataract surgery. Patients with concomitant dry eye disease require preoperative and postoperative treatment of dry eye to prevent aggravation of the existing symptoms that may affect the visual outcome after cataract surgery.

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