scholarly journals Modified Small Incision Cataract Surgery and Intraocular Lens Implantation in HIV Patients

2015 ◽  
Vol 7 ◽  
pp. OED.S31013 ◽  
Author(s):  
Kagmeni Giles ◽  
Christelle Domngang ◽  
Georges Nguefack-Tsague ◽  
Ebana Mvogo Come ◽  
Peter Wiedemann

Aim To describe a surgical technique suitable for cataract surgery in regions with a high prevalence of HIV infection. Methods We reviewed the medical records of 20 consecutive AIDS patients with cataract who underwent modified small-incision cataract surgery (mSICS) with posterior chamber lens implantation. Classic extracapsular cataract extraction (ECCE) was compared to mSICS. The number of potentially risky steps for contamination during surgery and duration of surgery were analyzed. A risky step was defined as any time when the surgeon had to use a sharp instrument. Student's paired t-test was carried out to compare continuous variables, and P-values <0.05 were considered statistically significant. Results Twenty patients were included in the study, 13 males (65%) and seven females (35%). The mean age was 46.3 ± 13.6 years (range 22–70 years). The number of potentially risky steps for contamination was significantly higher in the classical ECCE than in mSICS ( P < 0.001). The mean duration of cataract surgery with mSICS was significantly shorter as well ( P < 0.001). Conclusion Conversion to mSICS is essential in order to reduce accidental injuries during cataract surgery in sub-Saharan countries. Sharp instruments should be passed through a neutral zone to ensure that the surgeon and nurse do not touch the same instrument at the same time.

1970 ◽  
Vol 1 (1) ◽  
pp. 13-19 ◽  
Author(s):  
A Gurung ◽  
DB Karki ◽  
S Shrestha ◽  
AP Rijal

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


1970 ◽  
Vol 3 (1) ◽  
pp. 13-18 ◽  
Author(s):  
AK Khurana ◽  
U Chawla ◽  
N Passi ◽  
A Jyoti ◽  
A Archana ◽  
...  

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


1970 ◽  
Vol 22 (1) ◽  
pp. 132-135
Author(s):  
AKM Shahidur Rahman Tarafder ◽  
M Anwarul Kader ◽  
SM Rezaul Karim

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


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