Feasibility and Complications between Phacoemulsification and Manual Small Incision Surgery in Subluxated Cataract

K. P. S. Malik,Ruchi Goel,Sonam Angmo Bodh,Saurabh Kamal,Smriti Bansal,Jugal Kishore,Madhu Singh,Sushil Kumar

doi:10.1155/2012/205139

Abstract

Purpose. To compare the feasibility of cataract surgery with implantation of endocapsular supporting devices and intraocular lens (IOL) in subluxated cataract in phacoemulsification and manual small incision cataract surgery (MSICS). Design. Prospective randomized intervention case series consisting of 60 eyes with visually significant subluxated cataract. Method. The patients were randomly distributed between the two groups equally. The main outcome measure was implantation of in-the-bag IOL, requirement of additional procedure and complications, if any. Results. Capsular bag retention in subluxated lenses is possible in 90% cases in phacoemulsification versus 76.67% cases in MSICS (P = 0.16). Both groups, achieved similar best corrected visual acuity (P = 0.73), although additional procedures, intraoperative, and postoperative complications were more common in MSICS. Conclusions. Achieving intact capsulorhexis and nuclear rotation in MSICS may be difficult in cases with large nucleus size and severe subluxation, but subluxated cataracts can be effectively managed by both phacoemuslification and MSICS.

Highlights

Subluxated lenses present a serious challenge to every cataract surgeon
In group A, phacoemulsification and in group B, manual small incision cataract surgery was done with implantation of posterior chamber intraocular lens (IOL) and use of endocapsular supporting device as required
Capsular bag retention in subluxated lenses is possible in 90% cases of phacoemulsification and 76.67% cases of Manual small incision cataract surgery (MSICS)

Summary

Introduction

Subluxated lenses present a serious challenge to every cataract surgeon. The causes of subluxation of the lens include trauma, Marfan’s syndrome, Weill-Marchesani syndrome, homocystinuria, idiopathic, and hereditary cases. With the development of newer techniques and devices, complications in these cases have been reduced [1, 2]. These devices include capsular tension ring (CTR), modified CTR with single or double fixation point [1,2,3], capsular tension segment (CTS) [4], and recently introduced capsular anchor device [5]. The use of iris hooks [6] has further improved the stabilization of capsular bag during the cataract surgery.

Methods

Results

Conclusion