Abstract
ABSTRACTBackground: North-eastern region of India continue to suffer from limited resources, added upon by Mongoloid racial similarity and poor cataract surgery rate has contributed to the increase incidence of advanced cataract like phacomorphic glaucoma.Objective: To evaluate the visual prognosis and related complications of phacomorphic glaucoma cases by manual small incision cataract surgeries in North-eastern region of India.Materials and methods: This retrospective case series study includes 65 phacomorphic glaucoma cases diagnosed between June 2009 to December 2011 in Jawaharlal Nehru Institute of Medical Sciences, Manipur. Preoperative routine evaluation includes slit-lamp biomicroscopy, measurement of IOP, gonioscopy of fellow eye, axial length measurement, AC depth and lens thickness by A-scan. Manual small incision cataract surgery with intraocular lens implantation was performed in all the 65 eyes. Complete ophthalmic examination was done at each follow-up visit.Results: The mean preoperative IOP was 35.14 (±6.35) mm Hg and IOP at the 3rd month follow-up was 18.65 (±1.3) mm Hg with a statistically significant lowering of IOP (p < 0.0001) at the last follow-up. Intraoperative complications were minimal. Corneal edema, fibrinous exudates in AC was seen in few cases. Postoperative best corrected visual acuity was 6/6-6/12 in 46 eyes, 6/18-6/36 in 12 eyes, 6/60-3/60 in 4 eyes and less than 3/60 in three eyes. Antiglaucoma medication was discontinued immediately after each surgery.Conclusion: Manual small incision cataract surgery being inexpensive play a key role in management of poor outreach program marker like phacomorphic glaucoma in effectively controlling the IOP and achieving good visual acuity with minimal complications.How to cite this article: Rajkumari V, Kaminibabu KS, Bhabanisana RD, Victor R. Manual Small Incision Cataract Surgery in Phacomorphic Glaucoma: Surgical Technique and Outcome in North-eastern India. J Current Glau Prac 2013; 7(2):43-48.
Highlights
The estimated number of people visually impaired in the world currently is 285 million in which 39 million peoples are blind and 246 million people have low vision ( 3/60)
Manual small incision cataract surgery being inexpensive play a key role in management of poor outreach program marker like phacomorphic glaucoma in effectively controlling the intraocular pressure (IOP) and achieving good visual acuity with minimal complications
Well control studies have clearly shown the advantage of manual small incision cataract surgery over extracapsular cataract extraction in cataract surgery in terms of visual outcome and postoperative recovery which is crucial in such cases.[28]
Summary
The estimated number of people visually impaired in the world currently is 285 million in which 39 million peoples are blind and 246 million people have low vision ( 3/60). Age 50 years and older constitute the 65% of people visually impaired and 82% of all blind population.[1] Cataract alone account for 51% causes of global blindness.[1] Cataract has been documented to be the most common cause of bilateral blindness in India.[2,3,4,5]. Extrapolating the results of the survey to the general population, it was estimated that the 1.38% of the North-eastern population was blind (1.1% blind, overall generalized Indian population).[6] Even though the most common cause in this population is cataract, the number of cataract surgeries in these regions is far from the target. North-eastern region of India continue to suffer from limited resources, added upon by Mongoloid racial similarity and poor cataract surgery rate has contributed to the increase incidence of advanced cataract like phacomorphic glaucoma
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