Chapter-35 Phacosection: A Manual Small Incision No Stitch Cataract Extraction Technique

Purpose To describe a new technique to split rock-hard nuclei using an ultrasonic chopper (Ultrachopper) and a prechopper, in order to perform a modified small incision manual cataract extraction. Methods The Ultrachopper device, which is compatible with modern phacoemulsification systems, is used to facilitate the division of very hard nuclei in a straightforward manner using a manual prechopper, and the two fragments are extracted using Kansas forceps. Results In rock-hard nuclei, this technique is very effective to divide and extract the fragments. The risk of complications related to phacoemulsification on these very challenging cases is avoided. Conclusions This modified small incision manual cataract extraction technique, assisted with an ultrasonic chopper (Ultrachopper) and a prechopper, is a very good alternative in rock-hard nuclei.

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Novel technique of explantation of rigid phakic iris-claw lens and cataract extraction by sutureless manual small-incision surgery

BMJ Case Reports ◽

10.1136/bcr-2019-233128 ◽

2019 ◽

Vol 12 (12) ◽

pp. e233128

Author(s):

Prateek Agarwal ◽

Samuel Edward Navon ◽

Neha Mithal

Keyword(s):

Visual Acuity ◽

Cataract Extraction ◽

Blurred Vision ◽

Novel Technique ◽

Small Incision ◽

Complicated Cataract ◽

Uncorrected Visual Acuity ◽

Lens Surgery ◽

Iris Claw Lens ◽

Iris Claw

A 38-year-old patient presented to us with complaints of blurred vision and photophobia in the left eye with an uncorrected visual acuity of 20/400, improving to 20/60 with pinhole. The patient underwent phakic iris-claw lens surgery 15 years ago for high myopia. On examination, there was anterior chamber rigid phakic iris-claw lens along with complicated cataract. We planned for sutureless self-sealing 6.5 mm sclerocorneal tunnel for explantation of rigid phakic iris-claw lens along with cataract extraction with irrigating vectis. There was postoperative reduction in astigmatism due to incision planned on steep axis, and visual acuity improved to 20/30 uncorrected. This technique provides significant advantages from the previously described techniques in terms of decreased postop astigmatism, no need for sutures, no issues of chamber instability and iris trauma and without the need for phacoemulsification.

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Traumatic aniridia after small incision cataract extraction

Contact Lens and Anterior Eye ◽

10.1016/j.clae.2006.08.003 ◽

2006 ◽

Vol 29 (4) ◽

pp. 163-164 ◽

Cited By ~ 2

Author(s):

Hiten G. Sheth ◽

Alistair H. Laidlaw

Keyword(s):

Cataract Extraction ◽

Small Incision

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Visual outcome of conventional extracapsular cataract extraction with posterior chamber intraocular lens implantation versus manual small-incision cataract surgery

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v1i1.3668 ◽

1970 ◽

Vol 1 (1) ◽

pp. 13-19 ◽

Cited By ~ 4

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

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

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v1i2.3686 ◽

1970 ◽

Vol 1 (2) ◽

pp. 118-122 ◽

Cited By ~ 1

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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