Incidence, management, and outcome of complex cataracts in a tertiary eye set up

Dr Ritu Verma

doi:10.17511/jooo.2020.i08.02

Abstract

Aim: To study the incidence, management, and outcome of complex cataract cases in a tertiary eyecare center. Material and methods: Retrospective observational study with analysis of recordsdone for patients who were operated on for complex cataract from December 2019 to February2020. Results: 300/10,000 patients had complex cataracts requiring additional surgical skills,advanced equipment, and better patient counseling. 5.3% (16/300) of patients needed intracameraladrenaline whereas 1.3% (4/300) needed Visco mydriasis. A capsular tension ring was implanted in4.3%(13/300) of patients. 4% (12/300) underwent sphincterotomies whereas 2% (6/300) had toundergo synechiolysis. Iris hooks were used in only 0.6% of patients (2/300). Posterior capsularrent was seen in 1.6%(5/300) which was managed by placing a Posterior chamber IOL in the sulcus.2.6% (8/300) had implantation of the iris-claw lens and 2.3% (7/300) were left aphakic forsecondary IOL to be implanted at a later date. The visual outcome was better than 6/18 in 76% ofpatients. 24% of patients had an improvement in their visual acuity by a line or 2 but was less than6/18 due to corneal degenerations, corneal scarring, Retinal pathologies, and colobomas.Conclusion: Although these cataracts demand more expertise on behalf of the surgeon, theoutcome can be very rewarding if done with proper planning. The knowledge of small incisioncataract surgery is highly valuable in such situations.

Highlights

IntroductionIndia has been very successful in increasing its cataract surgical rate and now is at par with the estimate of 8000-8700 per million cataract surgeries to eliminate blindness [1,2]
These measures help to lower the chances of infection post-surgery.India has been very successful in increasing its cataract surgical rate and now is at par with the estimate of 8000-8700 per million cataract surgeries to eliminate blindness [1,2]
The District Blindness Control Societies organizes camps in remote villages that do not have access to hospitals leading to an increase in the number of patients enrolling for cataract surgery in each camp [3]

Summary

Introduction

India has been very successful in increasing its cataract surgical rate and now is at par with the estimate of 8000-8700 per million cataract surgeries to eliminate blindness [1,2] The reason for this surge in the rate of cataract surgeries is due to increased awareness among the population, increase in the facilities to accommodate more patients in the hospital premises, their transportation, and meals. Certain cataracts are at a higher risk of complications during surgery Surgery on such complex cataracts yields guarded visual outcomes even when they demand more surgical expertise and advanced machinery. Recognizing such complex cataracts helps us to be prepared to deal with the likely complications. It helps the OT personnel to make the necessary equipment ready and available during surgery [4]

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