Outcomes Of Small Incision Cataract Surgery Research Articles

Long-term outcomes of small-incision cataract surgery in patients with uveitis.

To evaluate the long-term outcomes of manual small-incision cataract surgery (MSICS) in eyes with uveitis. Patients who underwent MSICS for uveitic cataract from 2009 to 2019 were retrospectively evaluated. Visually significant cataract and presence of less than five cells per high-power field in the anterior chamber for a minimum of 3 months were the prerequisites for surgery. Patients with follow-up less than 9 months were excluded. After exclusion, 283 eyes of 264 patients were evaluated. The mean age of patients was 44.3 ± 11.3 years. The mean follow-up duration was 22 ± 11.5 months. The mean surgical time was 11.2 ± 3.2 min. One hundred and seventy-two eyes (60.8%) had anterior uveitis, 78 (27.5%) had posterior uveitis, and 33 (11.7%) had panuveitis. At the final follow-up, 253 eyes (88.4%) had corrected distance visual acuity (CDVA) better than 0.6 log of minimum angle of resolution (LogMAR) unit. The final endothelial cell counts were significantly (analysis of variance [ANOVA], P = 0.001) lower in eyes with human leukocyte antigen (HLA)-B27-associated uveitis and in eyes with idiopathic anterior uveitis. Patients on systemic corticosteroids had significantly better (P = 0.031) final visual acuity than those without preoperative corticosteroids. Recurrent uveitis (43.8%), Posterior capsule opacification (PCO) (19.4%), glaucoma (8.5%), cystoid macular edema (CME; 13.5%), and Epiretinal membrane (ERM) (5.6%) were the frequent complications. A significantly worse (ANOVA, P = 0.001) visual prognosis was seen in patients with Vogt-Koyanagi-Harada disease (VKH), sarcoidosis, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), and serpiginous choroiditis. MSICS is safe in most cataracts due to uveitis and results in improvement in CDVA at 9 months. Posterior capsule opacification, macular edema, persistent uveitis, etiology of uveitis, and use of preoperative steroids significantly influenced the visual outcome.

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

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

Outcome of surgery in a manual small incision cataract surgery training in Calabar, Nigeria

Background: Cataract is the leading cause of blindness in developing countries. Phacoemulsification is beyond the reach of many in these resources limited setting. Manual Small Incision Cataract Surgery (SICS) is a safe, low-cost, high-quality alternative. This is a review of outcome of SICS performed by trainee Surgeons during the first SICS training course in our centre. Patients and Methods: Eleven experienced Extracapsular Cataract Extraction (ECCE) surgeons from training centers across Nigeria were selected for a weeklong SICS training and conversion course. A review of visual outcome and complications of surgeries performed by these trainees on adult subjects is here reported. Results: Eighty-two eyes met the inclusion criteria. Male to female ratio was 1.4:1. Intraocular lenses were implanted in 80 eyes (97.5%). Visual outcome at 3 months post-operatively was good in 58 eyes (70.7%), borderline in 20 (24.4%), and poor in 4 (4.9%) subjects. The most common late post-operative complication, resulting in poor outcome was uncorrected aphakia in 2 (2.4%) eyes. Conclusion: The outcome did not meet World Health Organization (WHO) recommendations but was better than that reported for ECCE in the country. Conversion to SICS may not be difficult for competent ECCE surgeons as trainees achieved reasonable dexterity with acceptable post-operative outcome and complications profile in one week. To maximize patient safety and good outcome, a longer training period is recommended.

Loupe Magnification for Small Incision Cataract Surgery - an Alternative to Microscope Magnification?

A Prospective randomized controlled study was conducted to compare outcome of Small Incision Cataract Surgery (SICS) using microscope or loupe magnification. Two hundred fifty one patient with mature cataract were randomly allocated to SICS-Fishhook Technique with either microscope (127 eyes) or loupe (124 eyes) magnification. Intra- and postoperative complications and immediate visual outcome were analyzed. Nearly two third (microscope 65% and magnifying loupe 62.9%) of all patients had good visual outcome on first postoperative day. Poor outcome (<6/60) was recorded in 8% (microscope group) and 7% (magnifying loupe group). Mean visual acuity with Snellen was 0.39 (SD 0.2) in microscope group and 0.38 (SD 0.2) in magnifying loupe group. Intra operative complications were comparable in both groups. Mean surgery time with loupe magnification was significantly shorter. Comparatively equivalent good surgical outcome was achieved with loupe as well as with microscope magnification. However performing SICS with loupe magnification is significantly faster. Small incision cataract surgery with loupe magnification is safe and effective procedure for cataract surgery so it can play a role in reducing cataract blindness in developing countries of the world.