scholarly journals EVALUATION OF CAUSES OF EARLY POSTOPERATIVE HYPHEMA IN MANUAL SMALL INCISION CATARACT SURGERY.

2020 ◽  
pp. 18-20
Author(s):  
Gayatri Ravulaparthi ◽  
Sravanthi Singarapu ◽  
Sathya Vattikonda
Keyword(s):  
Surgical Technique ◽  
Cataract Surgery ◽  
Medical Records ◽  
Demographic Data ◽  
Complication Rates ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
The Common ◽  
Wound Construction

Background: Cataract surgery is the most commonly performed surgery in the world. Manual small incision cataract surgery (MSICS) is principally employed in resource poor settings and bulk of cataract surgeries are performed by this technique in the developing world. Results achieved by MSICS is comparable with phacoemulsification in achieving excellent visual outcomes with low complication rates. Hyphema is one of the common postoperative complication of MSICS. Aim: To estimate the incidence and evaluate the causes of early postoperative hyphema in MSICS. Design: Cross sectional observational study done on hospital based patients who underwent manual small incision cataract surgery between August 2019 and July 2020. Material and methods: The demographic data, operation notes and details of clinical examination done using slit lamp bio microscopy on the first postoperative day of 341 patients who underwent MSICS between August 2019 and July 2020 were obtained from the hospitals clinical medical records section. Surgical technique of wound construction and its relevance to the incidence of postoperative hyphema on the first postoperative day was analysed. Results: Out of 341 patients, 26 (7.6%) had hyphema on first postoperative day. The variation in the surgical technique and other causes that was frequently associated with postoperative hyphema were in the order as extension of the wound, deep tunnel, posterior incision site, premature entry and iridodialysis. In 3 patients we could not attribute hyphema to any known cause. Conclusion: A proper technique of wound construction helps avoid this potential complication and thus refinement goes a long way in keeping up the morale of the MSICS surgeon.

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 Comparison of endothelial cell loss and complications between phacoemulsification and manual small incision cataract surgery (SICS) in uveitic cataract

2016 ◽  
Vol 7 (2) ◽  
pp. 124-134
Author(s):  
Rahul Bhargava ◽  
Shiv Kumar Sharma ◽  
Mini Chandra ◽  
Prachi Kumar ◽  
Yogesh Arora
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Cell Loss ◽  
Complication Rates ◽  
Endothelial Cell Loss ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Cell Counts ◽  
Endothelial Cell Counts

Introduction: Endothelial cell loss and complications after cataract surgery may be higher when cataract is complicated by uveitis.Objective: To compare endothelial cell damage and complication rates after phacoemulsification and manual small incision cataract surgery (SICS) in patients with uveitis.Materials and methods: Patients with uveitic cataract were randomly allocated for phacoemulsification (n=75) or manual SICS (n=80) in a double blind prospective study. In the bag implantation of a hydrophobic acrylic intraocular lens was aimed in all cases. Patients with follow up of less than six months were excluded. Main outcome measures were alteration in endothelial cell counts (ECC) and morphology, improvement in vision and complication rates. ECC was measured preoperatively and at 1 week, 3 months and six months, postoperatively.Results: Six patients were lost to follow up and another three due inability to implant IOL. There were no significant difference in endothelial cell counts (P= 0.032), the variance of endothelial cell size (CV) and percentage of hexagonal cells between both the groups at six months (Mann-Whitney test, P=0.283). Endothelial cell density was significantly less in the group in which vitrectomy and/or pupil dilatation procedures were performed (2290±31.5 cells/mm2) versus (2385±50.3 cells/mm2), respectively (t test, P<0.001). Incidence of postoperative complications that were observed like persistent uveitis (P=0.591), macular edema (P=0.671) and PCO (P=0.678) and visual outcome (P=0.974) were comparable between the two groups.Conclusions: Manual SICS and phacoemulsification do not differ significantly in endothelial cell loss and complication rates in uveitic eyes. However, increased anterior chamber manoeuvring due to additional procedures may lead to significantly higher endothelial cell loss.

scholarly journals Tarif Pelayanan Pembedahan Katarak Pasien Jaminan Kesehatan Nasional dengan Teknik Fakoemulsifikasi dan Small Incision Cataract Surgery

2020 ◽  
pp. 193-202
Author(s):  
Riris Dian Hardiani ◽  
Tris Eryando
Keyword(s):  
Cataract Surgery ◽  
National Health ◽  
Social Insurance ◽  
Claim Data ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Average Hospital ◽  
Small Incision ◽  
Case Base

Abstrak Prevalensi kebutaan di Indonesia karena katarak pada penduduk berusia ≥ 50 tahun sebesar 3% dan salah satu biaya kesehatan terbesar di tahun 2017 adalah untuk pembedahan katarak. Untuk melakukan pembandingan tarif rumah sakit serta tarif Indonesian Case Base Groups (INA-CBG) pelayanan pembedahan katarak dengan teknik fakoemulsifikasi dan Small Incision Cataract Surgery (SICS) dilakukan penelitian potong lintang menggunakan data klaim Jaminan Kesehatan Nasional (JKN) Rumah Sakit “X”. Perbedaan tarif fakoemulsifikasi dan SICS dianalisis secara bivariat dengan Mann-Whitney. Dari 1278 pasien katarak, terbanyak adalah pasien laki laki, berumur ≥ 60 tahun, 84,7% pembedahan menggunakan teknik fakoemulsifikasi, dan 77,2% pembedahan dilakukan di rawat jalan. Untuk pelayanan rawat inap, fakoemulsifikasi terbanyak di ruang perawatan kelas 1 (50,0%) dan SICS di kelas 3 (65,4%). Rerata tarif rumah sakit untuk rawat jalan fakoemulsifikasi Rp 9.536.041,- ±1.336.734,03 dan SICS adalah Rp 7.438.924,- ±1.160.666,63 (p<0,05) sedangkan untuk rawat inap fakoemulsfikasi Rp 9.355.253,- ±2.288.647,36 dan SICS Rp 6.078.391,- ±1.854.308,65 (p<0,05). Rerata tarif INA-CBG fakoemulsifikasi rawat jalan adalah Rp 8.809.191,- ±218.193,55 dan SICS Rp 4.410.000 (p<0,05) sedangkan untuk rawat inap fakoemulsfikasi Rp 10.834.039,- ±2.019.676,19 dan SICS Rp 9.074.188 ±1.638.329,7 (p<0,05). Rerata tarif rumah sakit dan tarif INA-CBG untuk teknik pembedahan katarak dengan SICS baik rawat jalan maupun rawat inap lebih rendah dibandingkan dengan teknik fakoemulsifikasi. Tarif INA-CBG yang dibayarkan Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan untuk kedua metode pembedahan katarak pada pelayanan rawat jalan lebih rendah sedangkan untuk rawat inap lebih tinggi dibandingkan dengan tarif rumah sakit. Kata kunci: Fakoemulsifikasi, SICS, Katarak, JKN Abstract The prevalence of blindness in Indonesia due to cataracts in the population aged 50 years and above is 3%. However, one of the highest health costs in 2017 was on cataract surgery. To compare hospital tariff and Indonesian Case Base Groups (INA-CBG) tariff of phacoemulsification and Small Incision Cataract Surgery (SICS), a cross-sectional study was conducted using National Health lnsurance claim data at Hospital “X”. The differences between phacoemulsification and SICS tariff were analyzed using the Mann-Whitney test. From a total of 1278 patients, majority were males, aged 60 years and above. 84.7% of the patients went through a phacoemulsification procedure, 77.2% were outpatients. Most inpatients that went through a phacoemulsification were admitted to class 1 wards (50.0%) while a majority of those went through a SICS procedure were admitted to class 3 wards (65.4%). There were significant differences in the average hospital tariff between phacoemulsification and SICS for both outpatients’ (IDR 9,536,041 ±1,336,734.03 vs IDR 7,438,924 ±1,160,666.63;p<0.05) and inpatients’ (IDR 9,355,253 ±2,288,647.36 vs IDR 6,078,391 ±1,854,308.65; p<0.05) care. The average INA-CBG tariff also had significant differences between both procedures for outpatients’ care (phacoemulsification vs SICS: IDR 8,809,191 ±218,193.55 vs IDR 4,410,000;p<0.05) and inpatients’ care (IDR 10,834,039 ±2,019,676.19 vs IDR 9,074,188 ±1,638,329.7; p<0.05). The average hospital and INA-CBG tariff of SICS, for both outpatients and inpatients were lower than that of phacoemulsification. Although INA-CBG tariffs paid by the Social Insurance Administration Organization for Health or BPJS Kesehatan for both phacoemulsification and SICS procedures in outpatients was lower, the INA-CBG inpatients’ tariff was higher than the hospital tariff. Keywords: Phacoemulsification, SCIS, Cataracts, National Health Insurance (NHI)

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 Comparison of surgical technique and outcomes of phacoemulsification and manual small incision cataract surgery in management of phacomorphic glaucoma and analysis of the risk factors for developing phacomorphic glaucoma

2021 ◽  
Author(s):  
Jyoti Bhatt ◽  
Sindhuja Singh ◽  
Prakhar Chaudhary ◽  
Rahul Bhardwaj ◽  
Kunal Vikram Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Technique ◽  
Cataract Surgery ◽  
Care Center ◽  
Definitive Treatment ◽  
Control Group ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Good Visual Acuity ◽  
The Mean

Background: Phacomorphic glaucoma is highly prevalent in developing countries. In India, the prevalence of phacomorphic glaucoma is 3.91%. The definitive treatment of phacomorphic glaucoma is surgery. The purpose of our study was to compare the surgical technique and outcomes of phacoemulsification and manual small incision cataract surgery (MSICS), in management of phacomorphic glaucoma and analysis of the risk factors for developing phacomorphic glaucoma.  Methods: This was a hospital based retrospective study done at a tertiary eye care center, over a period of nineteen months. A rigorous protocol to diagnose phacomorphic glaucoma was followed. All patients were given IV mannitol 20%, before surgery. The study patients were divided in to phaco group and MSICS group. The data analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Results: Out of 99 phacomorphic glaucoma cases, 37 underwent phacoemulsification and 62 underwent MSICS. The total number of female patients was 66 (66.67%) and that of male was 33 (33.33%) with female to male ratio of 2:1. The mean age of presentation was 63.64±8.27 years. The overall mean IOP was 42.9±9.68 mmHg in both the groups. The mean axial length was 22.47±1.03 mm in study patients and 22.82±0.8 mm in control group, (p=0.0082). The mean AC depth was 2.54±0.53 mm for phacomorphic eyes and 2.69±0.5 mm for control groups, (p=0.04).  Conclusions: MSICS is effective, safe and inexpensive in controlling IOP and achieving good visual acuity with minimal complications in the management of phacomorphic glaucoma as compared to phacoemulsification. 

scholarly journals Visual Outcomes Following Small Incision Cataract Surgery (SICS) in Wangaya Hospital, Bali, Indonesia

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Krisnhaliani Wetarini ◽  
Putu Anindya Agrasidi ◽  
Ida Ayu Putri Kartiningsih ◽  
Ni Made Dwipayani ◽  
Harumi Purwa Prahesthy
Keyword(s):  
Surgical Technique ◽  
Cataract Surgery ◽  
Visual Impairment ◽  
Study Group ◽  
Postoperative Complication Rate ◽  
Small Incision Cataract Surgery ◽  
Visual Outcomes ◽  
Postoperative Visual Acuity ◽  
Small Incision ◽  
Cataract Patients

Cataract is considered as one of the causes of visual impairment and blindness globally and specifically in Indonesia. Manual small incision cataract surgery (SICS) is a surgical technique that is commonly performed to improve the visual outcomes among cataract patients. This study is aimed to determine the visual outcomes of cataract patients who had done the SICS and to evaluate its effectiveness. An observational study was carried out among cataract patients in Wangaya Hospital, Bali, Indonesia. Patient who underwent SICS procedures were followed-up to obtain their postoperative visual acuity and complications. A total number of 23 patients with 34 operated eyes were included in the study. Cataract was found as an important cause of visual impairment and blindness among the study group, with the number of preoperative blindness and visual impairment was 52.2% and 43.5%, respectively. On the other hand, the SICS procedure showed the results of good visual outcomes in 41.2% of operated eyes and reduced the number of blindness to 0.0% among the study group. There was only 1 (2.9%) complication found postoperatively, which was IOL decentration. In conclusion, the result from SICS surgery in Wangaya Hospital, Bali, Indonesia showed better improvement in visual outcomes and reducing the rate of blindness among cataract patients. The SICS also showed a low postoperative complication rate. Hence, SICS should be continually sustained as the surgical technique to be performed among cataract surgery patients.

A Descriptive Study of Intraoperative Complications in Manual Small Incision Cataract Surgery

2021 ◽  
Vol 8 (2) ◽  
pp. 75-79
Author(s):  
Dr. Divya Khatwani ◽  
Dr. Ajay Tammewar ◽  
Dr. Sneha Murade ◽  
Dr. Roopa Naik
Keyword(s):  
Developing Countries ◽  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Cataract Extraction ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Study Results ◽  
Developed World

Background: Senile cataract is the most common cause of reversible blindness in India and other developing countries. It is one of the significant social problem. Though phacoemulsification has become a routine procedure for cataract extraction in most parts of the developed world, it is not always appropriate either for its cost or the density of cataract involved in developing nations like India. Small incision cataract surgery is commonly performed surgery in developing countries. This procedure is safe, effective to increase the surgical outcome, reduces surgical time, easier to maintain instrumentation and at the same time affordable. The present study is undertaken to study the intraoperative complications and how best these complications can be minimized and managed. Methods: A total of 50 cases were studied from October 2020-January 2021. It is a hospital based, descriptive cross sectional study. Results: Intraoperative complications occurred in 10 cases (20%). It included iris prolapse in 3 cases (6%), tunnel related complications in 3 cases which included premature entry in 2 cases (4%) and button holing in 1 case (2%), Descemet membrane detachment in 1 case (2%), intraoperative miosis in 1 case (2%), intraoperative hyphema in 1 case (2%), capsule related complications in 1 case (2%) and PC rent in one case (2%). Conclusion: Over all the intraoperative complications of manual small incision cataract surgery are less and the procedure is well suited in our country, where there is a large number of backlog of cataract cases.

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