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

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 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

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 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 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 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.

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.

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 Visual outcome and complications of manual small incision cataract Surgery (MSICS) in a peripheral CMH

2015 ◽  
Vol 10 (1) ◽  
pp. 14-18
Author(s):  
Md Abdullah Al Masum ◽  
Md Kamrul Hasan Khan ◽  
M Anwar Hossain
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Cost Effective ◽  
Armed Forces ◽  
World Health ◽  
Military Hospital ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Cataract Patients

Introduction: Manual small incision cataract surgery (MSICS) is a cost-effective alternative to phacoemulsification cataract surgery for developing countries. This prospective study was carried out in Combined Military Hospital (CMH), Chittagong from October 2009 to March 2011 on 75 cataract patients who were operated by MSICS technique. Objectives: Aim of this study was to assess the visual outcome and complications of MSICS in a peripheral CMH. Methods: Seventy five cataract patients were operated by MSICS technique. All surgical procedures were performed by the principal author. Major per-operative and postoperative complications were documented. Visual outcome was assessed by Snellen’s visual acuity test 06 weeks after operation. Results: Uncorrected visual acuity (UCVA) was 6/6 – 6/18 in 57 (76.0%) patients, < 6/18 – 6/60 in 15 (20%) and < 6/60 in 03 (4.0%) patients. Best corrected visual acuity (BCVA) was 6/6-6/18 in 65 (86.7%) patients, < 6/18-6/60 in 07 (9.3%) and < 6/60 in 03(4.0%) patients. Visual outcome was good in 86.7% of patients according to World Health Orgnization (WHO) criteria and was not far away from the WHO expected outcome. Posterior capsule rupture was the most significant per-operative complication which was found in 7(9.3%) cases and surgically induced astigmatism was main postoperative complication that affected visual outcome. Mean postoperative astigmatism (against-the rule) was - 1.25DC. 14 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Conclusion: MSICS is a safe and cost-effective technique of extra-capsular cataract extraction where surgical skill and experience of the surgeon plays a significant role in the result. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22895 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

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