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.

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 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 Study of Intraoperative Complications in Small Incision Cataract Surgery, its Management and Visual Outcome

2016 ◽  
Vol 3 (1) ◽  
pp. 52 ◽  
Author(s):  
Mrunal Suresh Patil ◽  
Dhiraj Namdeo Balwir ◽  
Sonal Dua
Keyword(s):  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Visual Outcome ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Study Results ◽  
The Common ◽  
Iris Prolapse

Aims: To study the intraoperative complications in small incision cataract surgery and its management and to study the visual outcome following the management of intraoperative complications. Material and Methods: A total of 250 cases studied from who underwent SICS. Intraoperative complications were studied and managed. Visual outcome following these complications were studied by noting the best corrected visual acuity after day 1, 1<sup>st</sup> week, 3<sup>rd</sup> week, 6<sup>th</sup> week following surgery. Results: The total intraoperative complications were seen in 22 (8.8%) patients. Posterior capsule rent was seen in 6 eyes (2.4%). Iris prolapse in 5 eyes (2%). Descemet detachment was seen in 3 eyes (1.2%). Premature entry was seen in 3 eyes (1.2%). Capsulorrhexis extension was seen in 2 eyes (0.8%). Zonular dialysis was seen in 2 eyes (0.8%). Superior iridodialysis was seen in only one eye (0.4%). Out of 250 cases, 246 came for follow up till 6th week. 214 (85.6%) patients had post operative BCVA 6/6 at the end of 6<sup>th</sup> week, 25(10%) patients had 6/9, 5 patients (2%) had 6/12-6/18 and remaining 2 patients (0.8%) had 6/24-6/36 BCVA. Conclusion: The study results shows that in high quality cataract surgery (91.2% without intraoperative complications) 99% BCVA 6/18 or better can be attained. In our study incidence of intraoperative complications was 8.8% in which posterior capsular rent and iris prolapse were the common intraoperative complications.

scholarly journals Determinants of posterior capsular opacity after cataract surgery: a cross-sectional study

2019 ◽  
Vol 7 (2) ◽  
pp. 577
Author(s):  
Pratima Sahu ◽  
Amit Kumar Mishra
Keyword(s):  
Cataract Surgery ◽  
Average Duration ◽  
Extraction Procedure ◽  
Cataract Extraction ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Posterior Capsular Opacification ◽  
Cross Sectional ◽  
Posterior Capsular Opacity ◽  
Patient Department

Background: Posterior capsular opacification (PCO) which is also known as “after cataract” or “secondary cataract”, is the most common complication of cataract surgery, with an incidence of 20-50%. The current study was conducted in a tertiary hospital of Odisha with an objective to find out the determinants of PCO among patients with defective vision attending the outdoor patient department of Ophthalmology.Methods: A hospital based descriptive study was conducted among the patients attending the ophthalmology out patient department of a tertiary hospital of Odisha. The detail history regarding the type of surgical procedure used for cataract extraction and the type of Intra Ocular Lens (IOL) implanted, duration of post-operative period was collected from the available documents and ophthalmic examination of the participants.Results: In the present study, 184 participants were included and examined. Fifty percent of the participants had undergone conventional extra capsular cataract extraction procedure. In 86.95% participants, the IOL used was Poly Methyl Methacrylate lens (PMMA). In 26.08% of the participants the development of PCO was within 12 to 36 months of cataract surgery. The average duration of PCO development recorded for participants <20 years was 3 months.Conclusions: Most of the participants included in the study with PCO had undergone conventional ECCE surgery, implanted PMMA lens, IOL with round edge and had a duration of 12-36 months between cataract surgery and PCO development. The average duration of PCO development is less among younger participants which gradually increases with increase in age.

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 Hospital-based community cataract surgery: comparison of visual outcomes between conventional extra-capsular cataract extraction and small incision cataract surgery

1970 ◽  
Vol 1 (2) ◽  
pp. 118-122 ◽  
Author(s):  
P Karki ◽  
JK Shrestha ◽  
JB Shrestha
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Cataract Extraction ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Mean Values ◽  
Visual Outcomes ◽  
Small Incision ◽  
Statistical Program

Introduction: The small-incision cataract surgery is gaining popularity among the ophthalmic surgeons. Objective: To compare the visual outcome of conventional extra-capsular cataract extraction (ECCE) and small-incision cataract surgery (SICS) in a hospital based community cataract program. Materials and methods: A prospective interventional study without randomization was carried out including the patients undergoing cataract surgery by either conventional ECCE or manual SICS. They were followed up for 6 weeks postoperatively. The visual outcomes were compared between the two groups. Statistics: The statistical program Epi-Info version 2000 was used to analyze the data. Mean values with standard deviations, 95% CI and p value were calculated. The p value of <0.05 was considered significant. Results: Of 85 patients, 44 (M: F=10:34) underwent ECCE and 41 (M: F=15:26) SICS (RR= 0.71, 95% CI=0.42-1.2, p value=0.16). Unaided visual acuity on the 1st postoperative day in the ECCE group was e"6/ 18 in 22.7%,<6/18-6/60 in 63.6 %,< 6/60 in 13.7%, whereas in the SICS group, the same was e"6/18 in 70.7%,<6/18-6/60 in 22 %,< 6/60 in 7.3% (95% CI = 0.23 - 0.48, p=0.001). Best corrected visual acuity on the 6th week follow-up in the ECCE group was e"6/18 in 79.5%,<6/18-6/60 in 18.2 %,< 6/60 in 2.3% and in the SICS group the same was 6/18 in 90.5% and <6/18-6/60 in 4.9% (95% CI=0.44 - 0.73; p=0.0012). Conclusion: Both ECCE and SICS are good procedures for hospital based community cataract surgery but within the 6 weeks postoperative period SICS gives better visual outcome. Remarkably higher number of female patients can be provided service in a hospital based community cataract programme as compared to males. Keywords: cataract; small incision; extra-capsular DOI: 10.3126/nepjoph.v1i2.3686 Nep J Oph 2009;1(2):118-122

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