Small Incision Cataract Extraction Research Articles

Visual outcome and complications of phacoemulsification and manual small incision cataract extraction for age related cataract

The purpose of this study is to compare visual outcome and complications of manual small incision cataract surgery (MSICS) with posterior chamber IOL implantation (PC-IOL) and phacoemulsification with posterior chamber IOL implantation for age related cataract. The study compares the visual outcome and complications of MSICS and phacoemulsification with PC-IOL performed in 80 eyes at M & J Western Regional Institute of Ophthalmology (M&J WRIO) Ahmedabad, by assessing post operative Best corrected Visual acuity (BCVA), Surgically Induced astigmatism (SIA) and complications. This was an Institutional based cohort interventional randomized, prospective study. MSICS and Phacoemulsification was performed on 80 eyes at M & J WRIO. The intraoperative complications were documented. The parameters that were examined on 1 postoperative day, 1 week, and 6 weeks postoperatively included uncorrected visual acuity, best corrected visual acuity (BCVA) at 6 weeks, intra ocular pressure by non -contact tonometry and keratometry at 6 weeks to rule out SIA.Statistical analysis was performed using chi square test. p value <0.05 was taken as significant.: MSICS & phacoemulsification had similar visual outcomes post-operatively. Phacoemulsification group produced less mean SIA (1.27 D) compared to MSICS group (1.29 D) and lesser (5%) complications than the MSICS group (10%). The comparison of all three parameters was not statistically significant between the two groups.: Visual outcomes, SIA and complications were comparably the same in MSICS & phacoemulsification. Therefore, MSICS can be excellent alternative to phacoemulsification.

Profile of Cataract Surgical Patients at the National Eye Centre, Kaduna, Nigeria.

Cataract surgery has evolved over the years. This study aims to highlight the profile of the patients that underwent cataract surgery at a tertiary hospital with emphasis on patient demographics, surgical techniques performed, intraocular lens powers implanted, and the complications managed. A retrospective cross-sectional descriptive study of all patients who had undergone cataract surgery within two years at the National Eye Centre, Kaduna, Nigeria. Data extracted from the electronic version of the manual cataract surgical records included the patient's age, sex, comorbidities, technique of cataract surgery performed, the intraocular lens powers implanted, and complications encountered. Intraoperative and postoperative complications up to the twelfth week were considered. All patients had biometry-guided intraocular lens implantation. One thousand four hundred and seventy- two (1,472) patient records of all ages met the inclusion criteria with a male-female ratio of 1.4:1. The mean age was 51.4 ± 22.6 years. The difference in the mean age of the sexes was statistically significant (p=0.01) and 95% CI was 7.37- 10.40 years. Glaucoma was the commonest ocular comorbidity 142(9.65%) and only 5% (74) had systemic comorbidities. The mean intraocular lens (IOL) power was 19.25 ± 1.8Diopters (Range 10.5D to 26D). The commonest surgery performed was small incision cataract extraction with posterior chamber intraocular lens implant (SICS + PCIOL) 91.2% followed by Trabeculectomy with SICS + PCIOL (3.87%). Phacoemulsification accounted for 2.72% of surgeries. Intra-operative complications were posterior capsular rent in 7.1% (104) and vitreous loss in 4% (58). The commonest post-operative complications were corneal edema6.9% (103) and striae keratopathy 4.6% (68). Most cataract patients were male, above 50years of age and likely to be older than the females at surgery. The most performed surgical technique was small incision cataract surgery with posterior chamber intraocular lens implantation (SICS + PCIOL) while the mean intra-ocular lens power was 19.25 ± 1.8Dioptres. Globally accepted cataract surgical techniques utilizing recent technological advancements were employed with biometry-guided intraocular lens power calculation and implantation. Complications fell within the accepted global rates.

Two-mm chord manual small-incision cataract surgery with phacofracture: A brief exposition of the surgical technique.

We describe a surgical technique for manual small-incision cataract extraction with 2-mm chord incision with phacofracture. The authors describe a curvilinear 2-mm chord incision 1.5 mm behind the limbus and antiparallel to the limbus with back cuts of variable length; 1.5 mm for foldable lenses and 2.5-3 mm for the rigid nonfoldable lenses. Continuous curvilinear capsulorhexis with a 26-G bent needle cystitome (or Utrata forceps) is followed by cortical cleaving hydrodissection and cartwheeling of the nucleus into the anterior chamber. A specially designed Sahu modified vectis (SMV) and a flattened visco cannula are used for the phacofracture. The heminuclei are removed along their longitudinal axis and direct implantation of the pseudophakos. Surgically induced astigmatism was found to be a mean change in astigmatism of 0.14 DCyl when the axis was ignored. Corneal endothelial counts were not vastly different from the routine manual small-incision and phacoemulsification at 3 months of follow-up. The technique used here by the surgeon for cataracts of any C (1-5) or any P (1-5) to grade NC4 NO4 as graded by the LOCS III. Case selection is of paramount importance. Two-millimeter chord MSICS with phacofracture can deliver low astigmatism and good visual recovery in cataract surgery.

Clinical observation of different surgical methods in the treatment of diabetic hard nucleus cataract

Objective To investigate the clinical effect of different surgical methods in the treatment of diabetic patients with hard nuclear cataract. Methods From May 2016 to May 2018, 104 patients with diabetic hard core cataract were selected in Hangzhou Dajiangdong Hospital.According to the surgical methods, 53 cases were divided into small incision group and 51 cases in ultrasound group.The small incision group was treated with small incision cataract extraction, and the ultrasound group was treated by phacoemulsification.The changes of visual acuity and intraocular pressure preoperation and postoperative 1 week and 4 weeks were compared between the two groups.The levels of inflammatory factors preoperation and postoperative 3d, and the occurrence of postoperative complications were compared. Results The visual acuity of the small incision group at 1 week[(0.49±0.12)] and 4 weeks[(0.67±0.16)] after operation was higher than that before operation[(0.14±0.05)](t=19.600, P=0.000, t=23.018, P=0.000), and the visual acuity at 4 weeks after operation was higher than that at 1 week after operation (t=6.552, P=0.000). The visual acuity of the ultrasound group at 1 week[(0.46±0.15)] and 4 weeks[(0.64±0.14)] after operation was higher than that before operation [(0.15±0.07)](t=19.600, P=0.000, t=23.018, P=0.000), and the visual acuity at 4 weeks after surgery was increased compared with that at1 week after operation (t=6.329, P=0.000). The intraocular pressure of the small incision group at 1 week[(29.83±2.65)mmHg] and 4 weeks [(15.47±3.38)mmHg] after operation was lower than that of the ultrasonic group at 1 week [(35.39±3.24)mmHg] and 4 weeks after operation [(21.97±2.06)mmHg](t=9.596, P=0.000, t=11.787, P=0.000). In the small incision group, 3d after operation, the serum TNF-α [(52.41±6.28)μg/L]], IL-1β [(24.64±4.15)μg/L] and IL-6 [(34.12±5.32) μg/L] levels were lower than those in the ultrasound group[TNF-α (78.93±10.42)μg/L, IL-1β (38.92±4.86)μg/L and IL-6 (56.39±7.19)μg/L] (t=15.789, P=0.000, t=16.135, P=0.000, t=18.003, P=0.000). The incidence rate of postoperative complications in the small incision group [13.21%(7/53)] was lower than that in the ultrasound group [39.22%(20/51)] (χ2=9.146, P=0.000). Conclusion The effect of small incision cataract extraction in the treatment of patients with diabetic hard nuclear cataract is better than phacoemulsification, and it causes small inflammatory reaction and less complications.It is worthy of clinical reference. Key words: Cataract; Cataract extraction; Phacoemulsification; Diabetes mellitus

Phacotrabeculectomy versus Trabeculectomy with Small Incision Cataract Extraction in Eyes Presenting with Cataract and Glaucoma

Background: The association of glaucoma with cataract has been more frequent because of increase in life expectancy and the increased risk of cataract development in patient with glaucoma. Aim of the work: was to compare the outcome of phacotrabeculectomy versus subscleral trabeculectomy with small incision cataract extraction in patients with cataract and primary glaucoma. Patients and Methods: This prospective study included a total of 20 eyes of 19 patients with visually significant cataract and coexisting primary glaucoma. Patients were categorized randomly in two groups: group A who underwent phacotrabeculectomy and group B who underwent trabeculectomy with small incision cataract extraction from the same trab. Results: Statistically significant improvement was detected in postoperative BCVA and IOP. Preoperative BCVA ranged from 0.02 to 0.25 with the mean ±SD of 0.15± (0.07) in phacotrabeculectomy group (group A) while in small incision trabeculectomy group (group B) preoperative BCVA ranged from 0.01 to 0.25 with the mean ±SD of 0.11±(0.1). Preoperative IOP ranged from 30-35 mmHg with mean ±SD of 31.28 ± (1.25) in phacotrabeculectomy group while in small incision trabeculectomy group preoperative IOP ranged from 30-36 mmHg with mean ±SD of 31.14 ± (1.34). Conclusions: It could be concluded that there is significant improvement in the BCVA and IOP control after combined procedure for management of coexistent cataract and glaucoma. This improvement is statistically significant. There was no statistically significant difference in the final visual acuity, IOP control and postoperative complication rate between phacotrabeculectomy and small incision trabeculectomy.

A comparative study between topical ophthalmic nepafenac (0.1%) and ketorolac (0.5%) for their analgesic and anti-inflammatory effects in postoperative senile cataract patients attending a tertiary care center in West Bengal

Background: Ocular inflammation, which is common after cataract surgery, may cause patients to have postoperative pain and photophobia. Topical nonsteroidal anti-inflammatory drugs have been shown to be clinically effective in controlling inflammation after cataract surgery. Aim: The present study aims to compare topical ophthalmic nepafenac (0.1%) and ketorolac (0.5%) for their analgesic and anti-inflammatory effects in postoperative senile cataract patients. Materials and Methods: A total of 212 patients were included in the study and randomly allocated in two equal groups to receive either nepafenac (0.1%) or ketorolac (0.5%). Patients underwent cataract extraction on the scheduled date by manual small incision cataract extraction. The drug application was started on the day of operation. For both the groups, the drug was applied thrice daily. The ocular parameters were observed and noted down according to group assigned successively on day 1, day 3, day 7, day 14, and day 28. Results: There was no significant difference between the two drugs as far as visual acuity, and intraocular pressure outcome was concerned. The effect of nepafenac (0.1%) on anterior chamber cells and flare was more than ketorolac (0.5%) during 1st week (up to day 7), but at the end of the observation period (28 days), the effect was similar with both drugs. In nepafenac (0.1%) group, higher percentage of patients was free from pain and ocular discomfort than that of ketorolac (0.5%) group throughout the observation period. Conclusion: Nepafenac (0.1%) was found superior than ketorolac (0.5%) in dealing with ocular discomfort and pain and with respect to early recovery from anterior chamber inflammation.

Analysis on the efficacy of cataract surgery during the international aid to African "Brightness Action"

Objective To analyze the safety and efficacy of cataract surgery during the international aid to African Brightness Action . Methods The data of 280 eyes of 240 cases with cataract were collected during international aid to Cameroon Brightness Action from May 2016 to Jun. 2016. They underwent phacoemulsification or small incision cataract extraction and intraocular lens implantation. Results Followed up for 3 to 6 months, no endophthalmia, bullous keratopathy or other serious complication occurred after surgery. No cystoids macular edema, retinal detachment or secondary opacification of the posterior capsule happened. At 1-3 days postoperatively, the visual recovery rate was 98.21% and the visual acuity recovered from disability occupyed for 83.93%. The visual acuity at 1-3 days after surgery was ≥0.5 in 203 eyes (72.50%). At the end of the follow-up, the visual acuity was ≥0.5 in 266 eyes(95.00%), 0.05-0.25 in 8 eyes (2.97%). The main cause of low vision after surgery was ocular fundus disease. Conclusion The operation of large-scale cataract rescue operation during the international aid to Brightness Action is effective, the treatment is selected by phacoemulsification and small incision manual operation, the safety is reliable. Key words: Cataract; Brightness Action international aid to Africa; Phacoemulsificstion; Small incision extracapsular cataract extraction; Intraocular lens implantation

Efficacy of small incision non-phacoemulsification cataract extraction for the treatment of hard nucleus cataract

Objective To evaluate the efficacy of small incision non-phacoemulsification cataract extraction and intraocular lens implantation for the treatment of hard nucleus cataract. Methods The data of 198 eyes of 198 cases with hardness nucleus grades Ⅳ-Ⅴwere collected and they received small incision cataract extraction by manual nuclear fragmentation and implantation of intraocular lens. Results The eyes with best corrected visual acuity(BCVA) ≥0.5 accounted for 67.17% and BCVA≥1.0 for 36.36% 1 week after surgery.Three months after surgery the eyes of BCVA≥0.5 were in 93.43% and ≥1.0 in 75.76% .The astigmatism was (1.50 ± 0.75)D 1 week after surgery, and(0.75 ± 0.50)D 3 months after surgery .Postoperative complications were mild corneal edema in 19 eyes(9.60%), iritis in 13 eyes(6.57%), and posterior capsule mild turbidity in 14 eyes(7.07%). No serious complication occurred. Conclusion Small incision non-phacoemulsification cataract surgery is effective with low astigmatism, less complications and fast vision recovery .It avoides corneal injury caused by the ultrasonic energy. Key words: Cataract, hard nucleus; Cataract extraction, non-phacoemulsification, small incision

COMPARISON OF POST OPERATIVE CORNEAL ASTIGMATISM BETWEEN SMALL INCISION CATARACT SURGERY (SICS) AND EXTRA CAPSULAR CATARACT EXTRACTION (ECCE)

Background
 Cataract surgery is the most common type of surgery done by ophthalmologists. There are many methods of performing cataract surgery. Each of them has its own advantages and complications. Here we want to find the outcome of both the manual small incision cataract surgery and the conventional extracapsular cataract extraction surgery. 
 Objectives 
 To find the degree of postoperative corneal astigmatism in both manual small incision cataract surgery and the extracapsular cataract extraction surgery and compare these outcomes in both techniques.
 Patients and Methods
 We performed an experimental study conducted from January 2016 to June 2016 in Shahid Dr.Aso hospital ophthalmology department and Best Vision private hospital, Sulemani Province/Kurdistan Region of Iraq. One hundred cases were enrolled in the study, 50 cases underwent manual small incision cataract surgery and the other 50 underwent extracapsular cataract extraction surgery. All patients had their history taken, preoperative evaluation by (Slit-lamp examination, intraocular pressure measurement, indirect ophthalmoscopy for fundus examination, intraocular lens measurement, B-scan). Postoperatively; after 2 months, all cases in both groups were re-evaluated by the same measures of the preoperative examination.
 Results
 The mean postoperative uncorrected visual acuity in the manual small incision cataract surgery and extracapsular cataract extraction group was 6/9 and 6/12, respectively. The mean postoperative corneal astigmatism was 1.27+0.94 in manual small incision cataract surgery compared to 2.59+1.65 in the extracapsular cataract extraction surgery.
 Conclusion
 Both manual small incision and extracapsular cataract extraction techniques are safe and effective for visual rehabilitation of cataract patients. However, manual small incision cataract surgery gives better uncorrected visual acuity and less induced corneal astigmatism at 8 weeks postoperatively.

Clinical study of small incision cataract extraction in the treatment of acute angle-closure glaucoma complicated with cataract

Objective To study the clinical effect of small incision cataract extraction in the treatment of acute angle-closure glaucoma with cataract. Methods Fifty-eight patients with acute angle-closure glaucoma combined with cataract were selected, and according to the digital table they were randomly divided into two groups: control group and observation group.The patients in the control group were treated by conventional method.The patients in the observation group were treated with small incision cataract.The changes of intraocular pressure, anterior chamber depth and visual acuity before and after treatment were observed.The incidence of complications and the satisfaction of treatment were compared between the two groups. Results There were no significant differences in IOP, visual acuity and anterior chamber depth between the two groups before treatment(all P>0.05). After treatment, the intraocular pressure, anterior chamber depth and visual acuity of the observation group were (10.2±4.0)mmHg, (3.3±0.5)mm, (0.85±0.08), respectively, which of the control group were (17.5±5.0)mmHg, (3.2±0.5)mm and (0.50±0.06), respectively.The improvement of intraocular pressure and anterior chamber depth of the observation group was more significant than the control group(t=0.120, 0.520, 1.012, all P 0.05). Conclusion Small incision cataract extraction is an effective treatment for acute angle-closure glaucoma complicated with cataract, and the postoperative complications are less.The patients are satisfied with the treatment and deserve to be popularized. Key words: Cataract extraction; Glaucoma angle-closure; Cataract

Clinical observation on the interlaced non-phacoemulsification cataract extraction combined with intraocular lens implantation and keratoplasty

Objective To observe the efficacy of the interlaced non-phacoemulsification catatract extraction combined with intraocular lens implantation and keratoplasty(interlaced triple procedure). Methods Twelve eyes of 12 cases with cataract and keratonosus underwent the interlaced triple procedure.Nine cases of traumatic corneal leucom, 1 case of corneal degeneration, 1 case of viral keratitis and 1 case of fungal keratitis were collected. Surgery procedure: two-thirds thickness of corneal was trephined, then the scleral tunnel incision, capsulorhexis and delivery of nuclear were done. Then the cornea was trephined through and keratoplasty was completed. Finally, lens cortex was cleared and intraocular lens was implanted. Followed-up time was 1 - 3 years. The visual acuity, transparency and complications were observed. Results The uncorrected visual acuity of 11 eyes(91.7%) were improved compared with that of the preoperative.All the corneal grafts were completely transparent after operation in 2 weeks.Corneal grafts completely transparent after operation 1 year was in 9 cases.Corneal grafts of 1 case was semitransparent and 2 cases were moderately turbid. The total transparency rate was 75.00%.The complication was glaucoma in 1 case, and IOP was normal after trabeculectomy.The posterior capsule opacification occurred in 1 case, and the treatment was YAG laser.Two cases happened rejection. The rejection was controlled after anti-rejection therapy, and the corneal was opacity. Conclusion Triple procedure compared to the traditional triple procedure and staging surgery, the interlaced triple procedure can decrease postoperative complication and is high safety. Key words: Triple procedure, interlace; Small incision cataract extraction, non-phacoemulsification; Lens intraocular; Implantation; Keratoplasty, penetrating

Comparison of the therapeutic effects of two surgical methods for treating primary angle closure glaucoma with cataract

Objective To study the different clinical effects between the method of peripheral iridectomy+ trabeculectomy combined with cataract extraction with small incision+ intraocular lens implantation and the method of peripheral iridectomy+ trabeculectomy combined with cataract with phacoemulsification+ intraocular lens implantation , so as to provide guidance for clinic. Methods 40 cases were randomly divided into A and B groups, and A group included 19 patients (31 eyes), while B group included 21 patients (37 eyes). A group was treated with the peripheral iridectomy+ trabeculectomy combined with cataract extraction with small incision+ intraocular lens implantation method, and B group was cured with the method of peripheral iridectomy+ trabeculectomy combined with cataract with phacoemulsification+ intraocular lens implantation method.In each group, the eye pressures, visual acuity, central anterior chamber depths of before and after treatment were compared to study the clinical effect.And after treatment, the improvement amount of eye pressure, visual acuity, central anterior chamber depths and the complication rates were compared between the two groups, so as to determine the better method. Results After treatment, the eye pressure, visual acuity, central anterior chamber depths in A group were significantly improved[(21.71±10.17)mmHg, (0.29±0.09) and (1.97±0.47)mm, t=11.12, 6.93, 17.39, all P<0.05]. The eye pressure, visual acuity, central anterior chamber depths in B group were significantly improved[(19.45±9.54)mmHg, (0.35±0.16) and (1.98±0.39)mm, t=6.52, 5.78, 17.78, all P<0.05]. After treatment, the eye pressures in A and B groups were cut down[(21.74±10.17) and (19.45±9.54)mmHg], and there was no statistical significant difference between the two groups (t=0.96, P=0.17). The visual acuity in A and B groups were improved[(0.29±0.09) and (0.35±0.16) degrees], and there was no statistically significant difference between the two groups (t=1.86, P=0.97). The central anterior chamber depths in A and B groups were improved[(1.97±0.47) and (1.98±0.39)mm], and there was no statistically significant difference between the two groups (t=0.09, P=0.54). The incidence rates of complication in A and B groups were 48.39% and 21.62%, respectively, and the difference between two groups was significant (χ2=5.44, P=0.02). Conclusion The two treatments had significant and equal clinical effects, while because of its lower incidence rate of complication, the method of peripheral iridectomy+ trabeculectomy combined with cataract with phacoemulsification+ intraocular lens implantation is more safe than the other one. Key words: Primary angle-closure glaucoma; Cataract; Small incision cataract extraction; Phacoemulsification

Topical nonsteroidal anti-inflammatory drugs as adjuvant therapy in the prevention of macular edema after cataract surgery.

The purpose of the study was to assess adjuvant treatment with topical nonsteroidal anti-inflammatory drugs (NSAIDs) (0.9% bromfenac, 0.1% nepafenac, 0.5% indomethacin, or 0.1% diclofenac) in addition to topical steroidal treatment with 0.1% dexamethasone and 0.3% netilmicin for prevention of cystoid macular edema (CME) after uneventful small incision cataract extraction with foldable intraocular lens (IOL) implantation. Institute of Ophthalmology, Department of Scienze Mediche di Base, Neuroscienze ed Organi di Senso, Aldo Moro University, Policlinico Consorziale di Bari, Bari, Italy. A retrospective 6-month single center study. Patients were divided into groups according to treatment with topical drugs for 2weeks, after phacoemulsification with foldable IOL implantation. CME incidence was evaluated by assessing retinal foveal thickness changes using spectral domain optical coherence tomography. All patients were treated with a fixed combination of dexamethasone and netilmicin, and some patients were additionally treated with NSAIDs (bromfenac, nepafenac, indomethacin, or diclofenac). Fourteen patients were treated with bromfenac, 15 with nepafenac, 12 with indomethacin, and 14 with diclofenac; ten patients were treated with dexamethasone and netilmicin alone. At the end of the follow-up, macular thickness, evaluated at 1-week post-surgery, was reduced only in the group treated with nepafenac (-1.3%, p=0.048), was increased in the group treated with dexamethasone and netilmicin alone (+4.3%, p=0.04), and did not change in the groups treated with bromfenac (-1.1%, p=0.3), indomethacin (+0.1%, p=0.19), or diclofenac (+1.2%, p=0.74). There were no side effects in any group. Topical treatment with nepafenac, bromfenac, and indomethacin enhanced the efficacy of steroids to reduce postoperative macular edema. Diclofenac did not improve steroids efficacy.

Clinical analysis of cataract extraction combined with intraocular lens implantation in the treatment of glaucoma with cataract small incision cataract

Objective To observe the small incision cataract extraction and intraocular lens implantation for treatment of glaucoma with clinical cataract. Methods 92 cataract patients with glaucoma were randomly divided into the control and treatment groups of 46 cases by mathematical random number list.The control group was simple cataract excision; the treatment group were treated by using a small incision cataract extraction and intraocular lens implantation, and their clinical efficacy were observed. Results The effective rate of the treatment group was 91.3%, which was higher than that of 71.8% in the control group, the difference was statistically significant(χ2=3.86, P<0.05). The visual acuity recovery time and postoperative hospitalization time of the treatment group were (12.82±2.06)d and (17.49±2.65)d, which of the control group datas were (16.92±2.38)d and (19.74±3.15)d, the difference was statistically significant(t=16.534, 13.751, all P<0.05). In the treatment group, one case occurred adverse reactions, which was significantly less than the nine cases in the control group. Conclusion The clinical effectiveness of applicating small incision cataract extraction and intraocular lens implantation in the treatment of cataract patients with glaucoma is very obvious. Key words: Cataract extraction; Lens implantation, iutvaocular

Comparison on the effect of two types of surgeries for cataract after anti-glaucoma surgery

Objective To compare the clinical effect of two kinds of operation for treating cataract after anti-glaucoma surgery. Methods Sixty-seven eyes of 67 cases with cataract after anti-glaucoma filtering surgery were randomly divided into two groups: group A and group B. Thirty-four patiens in group A were treated with manual small incision cataract extraction through temporal scleral tunnel and posterior chamber folding intraocular lens implantation.Thirty-three patients in group B were treated with clear corneal incision phacoemulsification and posterior chamber folding intraocular lens implantation.The vision before operation and 1 month after operation, intraocular pressure and complications after operation were observed. Results One month after operation, there were 21 eyes with corrected vision more than 0.5 (61.8%) in group A, and there were 21 eyes (63.6%) in group B. Between two groups, the difference was not statistically significant(x2=0.03, P=0.91 ). There were 2 eyes with ocular hypertension symptoms in group A, and 4 eyes in group B. The IOP returned to normal after using IOP-lowering drugs in three days. The difference in intraocular pressure 1 month after the operation between two groups was not statistically significant(t=0.34, P=0.58). The average value of corneal astigmatism in group A was statistically significantly higher than that in group B in postoperative 1 week (t=6.58, P=0.00). There was no statistically significant difference in corneal astigmastism between two groups in postoperative 1 month (t=1.42, P=0.18). There were postoperative complications in both groups, however, there was no statistically significant difference in the number of cases. Conclusion Two kinds of operations for cataract after anti-glaucoma surgery are safe and effective. Now, transparent corneal incision phacoemulsification is a kind of ideal operation method in treating cataract after glaucoma surgery, but its operation equipment and materials are expensive and it needs higher request for surgical techniques. But temporal scleral tunnel manual small incision cataract operation in treating cataract after anti-glaucoma surgery is easy to operate with low cost and is suited for primary hosptial to carry out. Key words: Cataract, after anti-glaucoma surgery; Transparent corneal incision; Cataract surgery, manual, small incision; Phacoemulsification

Post-operative complications and visual outcome in eye camp patients undergoing sutureless cataract surgery at a Base Hospital in Vijayapura District, South India

Background: Cataract is the principal cause of blindness in India, accounting for 62.6%. This problem can be tackled, and the backlog of cataract blind can be reduced by performing cataract operations on a large scale. Base hospital approach with screening camps has shown good visual outcome with lesser complications. Aim and Objectives: To study the profile of postoperative complications and visual outcome in eye camp patients undergoing cataract surgery at the base hospital. Materials and Methods: In this cross-sectional study, 413 patients were included following screening at community screening camps. Patients underwent sutureless small-incision cataract extraction with intraocular lens implantation under local anesthesia at the base hospital. Postoperative complications and visual outcome were recorded. Results: Immediate postoperative complications were corneal edema (9.44%), striate keratitis (6.77%), expected uveitis (5.56%), secondary glaucoma (2.66%), residual lens matter (2.66%), iris prolapsed (0.48%) and shallow anterior chamber (0.24%), hyphema (0.24%) and iris incarceration (0.24%). Endophthalmitis was reported in 0.48% (one grew citrobacter, rarely reported). Late complications included posterior capsular opacification (3.87%) noted and retinal detachment (0.48%) later. Majority 83.39% of the patients had postoperative best corrected visual acuity (BCVA) between 6/6 and 6/18, 13.42% had BCVA between 6/18 and 6/60, 3.19% had BCVA < 6/60 as at 6 months follow-up visit (overall percentage is 100%). Conclusions: The overall vision-threatening complications after cataract extraction in the base hospital are low. Our study reflects the efficacy of the base hospital approach, in terms of visual and surgical outcome, as an important aspect from the public health point of view, which can help in clearing the cataract backlog in developing countries like India.

Stabilized triple procedure for management of coexisting corneal opacity and cataract

We describe a surgical technique combining penetrating keratoplasty and cataract surgery with a secure anterior chamber to manage coexisting corneal opacity and cataract. Lamellar corneal dissection is performed to 80% of the corneal depth to provide sufficient visibility for cataract surgery. Manual small-incision cataract extraction and intraocular lens implantation is performed through a frown-shaped scleral tunnel. Subsequently, 4 small penetrating incisions are made along the edge of the trephination mark at the 3, 6, 9, and 12 o'clock positions. A graft is placed on the ophthalmic viscosurgical device-coated stromal bed, and the 4 penetration sites are sutured. The stromal bed is cut along the trephination groove, the graft is sutured quadrant by quadrant, and the stromal bed is drawn out of the anterior chamber. The surgery is completed with 16 sutures.

Clinical effect of small incision cataract extraction with a manual nucleus division technique with intraocular lens implantation in cataract

Clinical effect of small incision cataract extraction with a manual nucleus division technique with intraocular lens implantation in cataract

Treatment of Congenital Aniridia Associated with Subluxated Infantile Cataract

A 5 year old boy was presented at Eye clinic University clinical center Tuzla with congenital aniridia in both eyes. Clinical examination revealed visual acuity of 0,08 without correction in right and 0.7 with -5.0 Dsph and -1.0 Dcyl Axx 109° in left eye. Opthalmologic examination showed bilateral aniridia associated with moderate cataract in the right and incipient cataract in the left eye. In the right eye, zonular weakness with incipient capsular displacement and esotropia of Δ6º, were noted. The patient underwent phacoemulsification, implantation of capsular tension ring and Artificial Iris implant in the capsular bag. Phacoemulsification went uneventful and early postoperative recovery was successful with no signs of aniridia-associated keratopathy development and normal values of intra ocular pressure. Patient was not motivated for operation of the left eye and it was corrected with soft contact lens. Six month after the operation visual acuity in the right eye improved to 0.9 with +1.25Dsph and maintained stable in left eye, with complete elimination of esotropia and signs of binocular vision restoration. Small incision cataract extraction with IOL and Artificial Iris implantation in one procedure can be used to correct congenital aniridia and cataract with significant visual function improvement.

Small incision cataract extraction and intraocular lens implantation in diabetic patients

Objective To evaluate the safety and efficacy of small incision cataract extraction and intraocular lens implantation in diabetic patients.Methods The study enrolled 277 eyes with cataract and they were divided into group A,group B and group C.Group A included 42 eyes with metabolic cataract and diabetic retinopathy.There were 96 eyes of metabolic cataract without diabetic retinopathy in group B.Group C included 114 cases (139 eyes) of senile cataract without diabetes.All cases underwent small incision cataract extraction and intraocular lens implantation successfully.36 eyes in group A also accepted retinal photocoagulation at 1 ～ 2 months postoperatively.Results Follow-up was 6 ～ 12 months.The visual acuities better than 0.3 at 3 months postoperatively were in 18 eyes (42.86％) in group A,85 eyes (88.54％) in group B and 129 eyes (92.81％) in group C.The difference between group A and group C was statistically significant (x2 =52.75,P ＜ 0.01).There was no statistically significant difference between group B and group C (x2 =1.27,P ＞ 0.05).Conclusion Small incision cataract extraction and intraocular lens implantation is safe and effective for diabetic patients which facilitates fundus examination and timely treatment of retinal diseases. Key words: Diabetes ; Cataract ; Lens , intraocular