The Outcome of Manual Small Incision Cataract Surgery and Anterior Vitrectomy for Persistent Fetal Vasculature in an 18-Year-Old Woman: A One-Year Follow-Up

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.

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Sumbawanga Augencamp follow-up Studie 2019

Der Ophthalmologe ◽

10.1007/s00347-019-00983-9 ◽

2019 ◽

Vol 117 (7) ◽

pp. 671-676

Author(s):

S. Irle ◽

E. Msigomba ◽

K. Paust

Keyword(s):

Cataract Surgery ◽

Small Incision Cataract Surgery ◽

Small Incision ◽

Therapeutische Möglichkeiten

Zusammenfassung Hintergrund Im Jahr 2019 hat das deutsche Komitee zur Verhütung von Blindheit (DKVB) ein Augencamp in der tansanischen Stadt Sumbawanga durchgeführt. Bei Patienten mit maturer Katarakt und intakter Lichtscheinwahrnehmung wurden Katarakte als „manual small incision cataract surgery“ (MSICS) operiert. Erstmalig wurde bei diesem Camp die Ergebnisqualität der durchgeführten Kataraktoperationen gemessen. Ziel der Arbeit Ziel war es, die Qualität der durchgeführten Kataraktoperationen darzustellen und die Ergebnisse in Zusammenhang mit den Vorgaben der Weltgesundheitsorganisation (WHO) zu bewerten. Methoden Patienten, die in den ersten Tagen des Augencamps kataraktoperiert worden waren, wurden in der zweiten Woche im Hinblick auf die Parameter Visus, Refraktion, spaltlampenmikroskopischer Befund und Komplikationen nachuntersucht, die Daten retrospektiv ausgewertet. Die Ergebnisse wurden mit den Vorgaben der WHO verglichen. Ergebnisse Es konnten 42 Patienten des Augencamps nach 5 bis 9 Tagen nachuntersucht werden. Folgende Parameter wurden gefunden: mittlere postoperative Sehschärfe 0,26, sphärisches Äquivalent −2,82 dpt, Astigmatismus −2,2 dpt/113 Grad; Visus >0,3 in 14,2% (WHO 80%), Visus 0,1–0,3 62% (WHO 15%), Visus <0,1 in 23,8% (WHO 5%); verzögerter Heilungsverlauf in 29% der Fälle. Schlussfolgerung Obwohl es zu einer Besserung des Sehvermögens kam, sind die Ergebnisse ernüchternd im Vergleich zu den Vorgaben der WHO. Postoperativ zeigen sich ein myoper Shift und ein Astigmatismus gegen die Regel. Die Gründe sind: okuläre Komorbiditäten, eingeschränkte diagnostische und therapeutische Möglichkeiten, Ausbildungscharakter des Camps, erschwerte Rahmenbedingungen und fortgeschrittene Befunde. Die Ergebnisse der Studie sind wichtig, um die Qualität der eigenen Arbeit einschätzen zu können und um das Potenzial für künftige Verbesserungen ausloten zu können.

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

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i2.14962 ◽

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.

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Correlation between visual acuity at discharge and on final follow-up in patients undergoing manual small incision cataract surgery

Indian Journal of Ophthalmology ◽

10.4103/ijo.ijo_986_20 ◽

2021 ◽

Vol 69 (3) ◽

pp. 586

Author(s):

Anika Amritanand ◽

DeepthiE Kurian ◽

Monseena Mathew ◽

Mable Keziah ◽

Grace Rebekah

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Small Incision Cataract Surgery ◽

Small Incision

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Astigmatic decay following small incision, self-sealing cataract surgery: One-year follow-up

Journal of Cataract & Refractive Surgery ◽

10.1016/s0886-3350(13)80535-4 ◽

1995 ◽

Vol 21 (4) ◽

pp. 433-436 ◽

Cited By ~ 15

Author(s):

Stan H. Feil ◽

Alan S. Crandall ◽

Randall J. Olson

Keyword(s):

Cataract Surgery ◽

Small Incision ◽

One Year

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Pseudophakic cystoid macular edema after uneventful small incision cataract surgery

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20175460 ◽

2017 ◽

Vol 5 (12) ◽

pp. 5386

Author(s):

Abhishek Ghelani ◽

Khushnood Sheikh ◽

Manisha Shastri ◽

Abhishek Patel

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Macular Edema ◽

Cystoid Macular Edema ◽

Anterior Segment ◽

Clinical Profile ◽

P Value ◽

Small Incision Cataract Surgery ◽

Small Incision

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.

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OUTCOME OF SMALL-INCISION CATARACT SURGERY AND PHACOEMULSIFICATION IN TERM OF VISUAL ACUITY AND POST OPERATIVE ASTIGMATISM.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i4.213 ◽

2019 ◽

Vol 3 (4) ◽

Author(s):

Dr Rishi Gupta

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Tertiary Care ◽

Care Hospital ◽

Small Incision Cataract Surgery ◽

Visual Rehabilitation ◽

Small Incision ◽

Uncorrected Visual Acuity ◽

Better Than

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

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Impact of Ophthalmic Viscosurgical Devices in Cataract Surgery

Journal of Ophthalmology ◽

10.1155/2020/7801093 ◽

2020 ◽

Vol 2020 ◽

pp. 1-17

Author(s):

Monali S. Malvankar-Mehta ◽

Angel Fu ◽

Yasoda Subramanian ◽

Cindy Hutnik

Keyword(s):

Cataract Surgery ◽

Meta Analysis ◽

Grey Literature ◽

Database Search ◽

Small Incision Cataract Surgery ◽

Small Incision ◽

Corrected Visual Acuity ◽

Soft Shell ◽

Standardized Mean Difference

Background. Ophthalmic viscoelastic devices (OVDs) used during small-incision cataract surgery have numerous advantages. However, OVDs have longer retention time in an eye after surgery resulting in intraocular pressure (IOP) spikes. The purpose of this study is to analyze and quantify the effect of various OVDs on both IOP and best corrected visual acuity (BCVA) by systematically reviewing the literature and performing meta-analysis. Methods. Numerous databases from January 1, 1985, to present were systematically searched. Thirty-six (3893 subjects) of 3313 studies identified were included for analysis. Standardized mean difference (SMD) was computed, and meta-analysis was performed. Results. A total of 3313 records were retrieved including 1114 from database search and 2199 from grey literature search. Significant increase in postoperative IOP in 1-day follow-up with Healon (SMD = 0.37, CI: [0.07, 0.67]), Viscoat (SMD = 0.29, CI: [0.13, 0.45]), Provisc (SMD = 0.46, CI: [0.17, 0.76]), and Soft Shell (SMD = 0.58, CI: [0.30, 0.86]) was computed. On the other hand, results implied a nonsignificant increase in postoperative IOP with Healon GV (SMD = 0.07, CI: [−0.28, 0.41]), Healon5 (SMD = 0.15, CI: [−0.33, 0.64]), 2% HPMC (SMD = 0.32, CI: [−0.0, 0.64]), and OcuCoat (SMD = 0.26, CI: [−0.37, 0.9]). Additionally, a nonsignificant reduction in postoperative IOP was inferred with Viscoat + Provisc (SMD = −0.28, CI: [−2.23, 1.68]). Conclusion. Improvement in IOP was shown with Viscoat + Provisc. Additionally, IOP nonsignificant upsurge was observed with Healon GV, Healon5, 2% HPMC, and OcuCoat compared to significant upsurge with Healon, Viscoat, and Soft Shell.

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Comparison of Nonphaco small incision Cataract Surgery with Conventional Method: An Observational Study

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v5i2.43027 ◽

2019 ◽

Vol 5 (2) ◽

pp. 185-190

Author(s):

Shamima Sultana ◽

AQM Omar Sharif ◽

Nazneen Begum ◽

Salma Parveen ◽

Wahida Begum ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Conventional Method ◽

Perioperative Complications ◽

Age Distribution ◽

Small Incision Cataract Surgery ◽

Small Incision ◽

Uncorrected Visual Acuity ◽

Cataract Patients

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

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