scholarly journals COMPARISON OF POST OPERATIVE CORNEALASTIGMATISM FOLLOWING FROWN VERSUS CHEVRON INCISION IN MANUAL SMALL INCISION CATARACT SURGERY

2020 ◽  
pp. 1-3
Author(s):  
Vabita Bhagat ◽  
Anu Radha Bharti* ◽  
Dinesh Gupta

Introduction: To study the comparison of post operative corneal astigmatism following frown versus chevron incision in manual small incison in manual small incision cataract surgery. Material and Methods:The study was conducted at govt. medical college jammu over a period of one year. The study includes a total of 100 pts. With age related cataract and were divided into two groups of 50 each. Detailed ocular examination of the cases with calculation of preoperative astigmatism were carried out in eye OPD. Results: st rd th th st All cases were assessed postoperatively at 1 , 3 , 6 and 12 week for surgical induced astigmatism .At the end of 1 week surgical induced astigmatism of more than 1D was seen in 72% pts. of group 1 with frown incision as compared to 48 % in group 2 with chevron incision. At the end of 12 weeks 54% of cases in group 1 with frown incision and only 8% in group 2 with chevron incision had astigmatism of more than 1 D. The difference between the two groups was statistically signicant. Conclusion: It is possible to reduce the amount of postoperative astigmatism signicantly by choosing the incision shape .Surgical induced astigmatism is less seen in patients with chevron incision as compared to patients with frown incision.

2019 ◽  
Vol 16 (3) ◽  
pp. 168-178
Author(s):  
Anu Malik ◽  
Smruti Ranjan Dethi ◽  
Yogesh Kumar Gupta ◽  
Alka Gupta

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification. Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively. Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2. Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.


2014 ◽  
Vol 25 (2) ◽  
pp. 72-74
Author(s):  
Md Abdur Rashid ◽  
Kh Anowar Hossain ◽  
AKM Rafiqul Islam ◽  
Zahir Uddin

This prospective study was designed to evaluate and compare surgically induced astigmatism in small incision cataract surgery through superior, supero-temporal and temporal approach. Astigmatism means no point focus. It is a refractive error that occurs when the optical system does not have the same refractive power at all its meridian. The location and width of incision will determine the amount of surgically induced astigmatism (SIA) in small incision cataract surgery. Temporal and superotemporal incisions are less likely to induce post operative astigmatism than the 12 o' clock incisions. The study was carried out at Tairunnessa Memorial Medical College and Hospital, Gazipur, Faridpur Diabetic Association Medical College and Hospital, Faridpur and General Hospital, Faridpur, Bangladesh, from January 2012 to June 2013.Total number of 120 eyes of 108 patients, both male and female patients were included for the study. We excluded the patients having corneal scar, irregular astigmatism, presence of pterygium and previous intraocular surgery from our study. The mean patient age at the time of surgery was 61.9±8.1 years ranged from 40 to 70 years.The patients were divided into three groups.The three groups had 40 patients each. The patients in group-A underwent manual SICS with a superior incision, the patients in group-B underwent manual SICS with a supero-temporal incision and the patients in group-C underwent manual SICS with a temporal incision. The small incision cataract surgeries were done by applying same surgical technique.The courses of the post operative astigmatic changes were determined by using Auto Refracto Keratometer at 1st week, 6th weeks and 12th week postoperatively. DOI: http://dx.doi.org/10.3329/medtoday.v25i2.17925 Medicine Today 2013 Vol.25(2): 72-74


2021 ◽  
Vol 6 (1) ◽  
pp. 1280-1284
Author(s):  
Roshan Dev Yadav ◽  
Kabindra Bajracharya ◽  
Neelam Shrestha ◽  
Kriti Joshi ◽  
Aman Kumar Gupta

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.


2015 ◽  
Vol 2 (2) ◽  
pp. 67
Author(s):  
Mrunal Suresh Patil ◽  
Dhiraj Namdeo Balwir ◽  
Amal Gupta ◽  
Ishan Kataria ◽  
Sumit Chatterjee

<strong>Aim</strong>: To compare different technique of nucleus delivery in small manual incision cataract surgery,regarding their safety and intra operative complication. <strong>Material &amp; Methods</strong>: A total of 285 patients with cataract undergoing SICS with posterior chamber IOL implantation were selected. Patients were randomly divided into 7 groups of nucleus delivery. All of the patients were followed up on first postoperative day and discharge. Patients were advised regular follow up at 1<sup>st</sup> week, 4<sup>th</sup> week and 6<sup>th</sup> week. <strong>Results</strong>: Out of total 285 patients 68 (23.86%) patients had intraoprative complications for all the techniques. There was no intraoperative difficulty to the surgeon for delivery of nucleus by various techniques in 210(73.68%) of cases. Group 1 (wire vectis) had minimum intraoperative complications whereas group 2 had maximum.31 (10.88%)had grade 1 (minimal) difficulty intraoperetively. 25 (8.77%)cases had grade 2 (moderate) difficulty. 19 (6.67) cases had grade 3(abandoned) difficulty. <strong>Conclusion</strong>: By adjusting parameters like size of cornean incision, hydrodissection or debulking of nucleus before delivery of nucleus in different grades of hardness of cataract, a surgeon may choose any one technique in which he or she is comfortable. Manual small incision Cataract surgery with its low complication rate has now come to be established surgical procedures for cataract surgery.


Author(s):  
Gannaram Laxmiprasad ◽  
Chhaya Shori ◽  
Rakesh Shori ◽  
Ashalatha Alli

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.


Author(s):  
Abhishek Salwan ◽  
Shakeen Singh

Background: Cystoid macular edema (CME) is the formation of fluid-filled cystoid spaces between the outer plexiform and inner nuclear layers of the retina. It may present as a complication of routine cataract surgery including phacoemulsification (PHACO) and small incision cataract surgery (SICS).Methods: An observational study of uncomplicated cataract surgery with assessment by ophthalmoscopy, slit Lamp, Snellen chart and OCT during pre- and post-operative period. 100 patients were selected by inclusion criteria and using convenient sampling technique and were divided into two groups of 50 each in PHACO and SICS groups.Results: During preoperative observation in SICS/group-1, mean value and SD of macular thickness was 223.38±12.61 and in PHACO/group-2 it was 224.14±12.69. Mean value, mean difference and p value of visual acuity in group 1 was 0.258, during 12 weeks 0.788 with mean difference -0.53 and p=0.000 and in group 2 it was 0.269, during 12 weeks 0.844 with mean difference -0.58 and p=0.000. Mean value, SD, mean difference and p value of macular thickness in SICS during 1 week was 238.28±12.29, during 12 weeks 227.04±12.58 with mean difference 11.24000 and p=0.000 and in PHACO mean value, SD, mean difference with p value during 1 week was 231.90±12.42, during 12 weeks was 225.02±11.74 with mean difference 6.88000 and p=0.000.Conclusions: A subclinical increase in post-operative macular thickness was recorded which returned nearly to baseline values during the 12 weeks follow up and did not affect visual outcome.


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