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

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.

Author(s):  
Dr Rishi Gupta

Objective: To compare the outcome of Small-incision cataract surgery and Phacoemulsification in term of visual acuity and post operative astigmatism Methods: A retrospective study carried out on 100 eyes of 100 patients from January 2017 to June 2017 at tertiary care hospital. All patients with senile cataract (up to grade IV) operated with SICS or Phacoemulsification were included. Records on all examinations including visual acuity, refraction, biometry, slit lamp biomicroscopy and fundoscopy from the period before surgery up to 6 weeks post-operatively were obtained. Result: The present study reports clinical outcomes of Small-incision cataract surgery and Phacoemulsification up to 6 weeks. Out of 50 patients 34 (68%) patients in the phacoemulsification group and 31 (62.%) of 50 patients in the small-incision group had uncorrected visual acuity better than or equal to 6/18 at 1 week. 41(82%) patients of the phacoemulsification group and 35 (70.%) patients of the small-incision group were better than or equal to 6/18 at the 6-week follow-up for presenting visual activity. Visual acuity improved to 6/18 with best correction in 49 patients (98 %) and 48 (96%) patients respectively. The mode of astigmatism was 0.5 diopters (D) for the phacoemulsification group and 1.5 D for the small-incision group, and the average astigmatism was 1.0 D and 1.3 D, respectively. Conclusions: Both the phacoemulsification and the small-incision techniques are safe and effective for visual rehabilitation of cataract patients, although phacoemulsification gives better uncorrected visual acuity and faster recovery


2019 ◽  
Vol 5 (2) ◽  
pp. 185-190
Author(s):  
Shamima Sultana ◽  
AQM Omar Sharif ◽  
Nazneen Begum ◽  
Salma Parveen ◽  
Wahida Begum ◽  
...  

Background: Cataract surgery is very important for the correction of visual acuity among the patients. Objective: The purpose of the present study was to assess the uncorrected visual acuity in small incision cataract surgery (SICS) with PCIOL than conventional method of ECCE with PCIOL implantation. Methodology: This cross-sectional study was conducted at National Institute of Ophthalmology, Dhaka, Bangladesh from January 1999 to December 2000 for a period of two (02) years. Patients with senile cataract were selected for study. A comparative study of changes in postoperative visual outcome and refractive status during post-operative follow up period up to 2 months were observed and documented between two groups of patients, one with suture less nonphaco SICS with PCIOL another with conventional ECCE with PCIOL. All the cataract surgery were done by the same surgeon, and in same place. All the patients were examined carefully both pre and post-operatively. For the purpose of recording, a proforma was made that includes particulars of the patient, complete history, general examination, ocular examination, relevant investigations, operation note, perioperative complications, post-operative follow-up, pre and post-operative visual acuity with keratometric reading. Result: A total of 60 eyes of cataract patients were included in the study of which 30 eyes of cataract patients were randomly selected for suture less nonphaco SICS with PCIOL and 30 eyes of cataract patients were for conventional ECCE with PCIOL.Mean age distribution (58.83±5.55 and 58.77±6.56) was similar in both groups. The unaided vision in both SICS & ECCE group at different postoperative intervals was reported. At day7 and month 1 postoperatively the result appears highly significant between the two groups. At day 1 and month 2 also shows the significant result between the 2 groups. The best corrected visual acuity in SICS and ECCE group at different postoperative intervals was measured. At day 7 and month 1 postoperatively the result appears highly significant between the two groups. At day 1 and month 2 also shows the significant result between the 2 groups.In SICS group out of 30 patients, 7(23.3%) cases acquired unaided vision 6/9 at day 1, 10(33.3%) patients at day 7,14(46.6%)patients at month 1 and 15(49.9%) patients at month 2. On the other hand in ECCE group no patient was found with vision ≥6/9 at day 1 and only one patient with vision ≥6/9 at day 7.At month 1 there were 5(16.6%) patients, and at month 2 there were 9(29.9%)patients with vision ≥6/9. Nearly 50.0% patients of SICS group achieve unaided vision of ≥6/9 within the follow up period of 02 months. Conclusion: In conclusion Uncorrected visual acuity in SICS cases were better than that of ECCE cases with sutures. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 185-190


2021 ◽  
Vol 69 (3) ◽  
pp. 586
Author(s):  
Anika Amritanand ◽  
DeepthiE Kurian ◽  
Monseena Mathew ◽  
Mable Keziah ◽  
Grace Rebekah

2016 ◽  
Vol 12 (1) ◽  
pp. 10-13
Author(s):  
Sanjib Kr Chaudhary ◽  
Shailesh Mani Pokhrel ◽  
Manoj Sharma ◽  
Badri Prasad Badhu ◽  
Bhuwan Govinda Shrestha ◽  
...  

Background & Objectives: Capsulotomy is one of the important step in cataract surgery which can affect the surgical outcomes. The aim of the study was to compare the outcomes of envelope and continuous curvilinear capsulorhexis technique in manual small incision cataract surgery (MSICS). Materials & Methods: A total of 72 eyes of 72 patients undergoing MSICS were studied. The patients were equally divided into two groups i.e. 36 patients each in envelope capsulotomy (Group A) and continuous curvilinear capsulotomy (CCC) group (Group B).Results: Mean surgical time (±SD) in Group A was 355.83 sec ±37.79 sec and in Group B was 375 sec ±31.214 (p=0.02). Uncorrected visual acuity on postoperative day 1 was 6/9 or better in 50% (18) cases in Group A and in 36% (13) cases in Group B (p=0.28). Best corrected visual acuity (BCVA) on post-operative week 12 was 6/9 or better in 30.6% (n=11) cases in Group A and in 36% (n=13) cases in Group B (p=0.43). On 12th week postoperatively, Grade 2 posterior capsular opacification (PCO) was seen in 30.6 % (n=11) cases of Group A and in 16.6 % (n=6) cases of Group B (p=0.17). Conclusion: CCC technique can be considered superior to envelope technique for long term visual rehabilitation.JCMS Nepal. 2016;12(1):10-13.


Author(s):  
Riris Dian Hardiani ◽  
Tris Eryando

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)


2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Indra Tri Mahayana ◽  
Reny Setyowati ◽  
Tri Winarti ◽  
Suhardjo Prawiroranu

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


Author(s):  
Abhishek Ghelani ◽  
Khushnood Sheikh ◽  
Manisha Shastri ◽  
Abhishek Patel

Background: To study the clinical profile of patient undergone small incision cataract surgery. To measure the incidence of CME after manual SICS and phacoemulsification method of cataract extraction.Methods: It`s a hospital based prospective study carried in ophthalmology dept. patients with normal clinical profile with no history of hypertension, diabetes mellitus, or any ocular trauma or infection/inflammation are randomly selected for cataract surgery either phacoemulsification or manual SICS and were regularly followed till sixth week after cataract surgery. During follow up complete examination including visual acuity, anterior segment examination fundoscopy and FFA done.Results: Out of 115 patients, 59 were operated by phacoemulsification and 56 were operated by manual SICS. 59were operated by phaco, 9 patients lost in follow up. Out of these, 2 patients developed CME. One was operated by phaco and the other by SICS (P value = 1.000) BCVA 6/9 or more after second follow up was seen in 42.45% of phaco patients and 40.56% of SICS patients which is statistically insignificant (P value = 0.343607).Conclusions: With advent of modern cataract surgery, rapid visual rehabilitation and unaided best corrected visual acuity is achieved with negligible early and late postoperative complications and thereby cystoid macular edema.


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.


2021 ◽  
Vol 8 (2) ◽  
pp. 75-79
Author(s):  
Dr. Divya Khatwani ◽  
Dr. Ajay Tammewar ◽  
Dr. Sneha Murade ◽  
Dr. Roopa Naik

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.


2021 ◽  
Vol 3 (6) ◽  
pp. 101-104
Author(s):  
P. A. A. S. Surya ◽  
N. N. Sunariasih

Cataracts are the second most common cause of blindness in the world at 33%. The incidence of cataracts is 0.1% of the total population, so the number of new cataract cases in Indonesia is estimated at 250,000 per year. This study aims to compare the visual acuity of post cataract surgery patients with Small Incision Cataract Surgery and Phacoemulsification techniques at Sanjiwani Hospital, Gianyar. This study was a retrospective cohort at Ophthalmologist’s Outpatient Departement of Sanjiwani Hospital, Gianyar, Bali. The sample of this study was 60 patients with 84 eyes with senile cataract. The surgical techniques performed were Small Incision Cataract Surgery (53.6%) and Phacoemulsification (46.4%). After that, an Uncorrected Visual Acuity (UCVA) examination was carried out on day 1 and day 42. The result were cataract patients at Sanjiwani Hospital, Gianyar aged 60-65 years who were male. Comparison of visual acuity after Small Incision Cataract Surgery and Phacoemulsification had the same results. On day 1 and day 42, there was no different uncorrected visual acuity result between Small Incision Cataract Surgery and Phacoemulsification statistically.


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