Small Incision Group Research Articles

The small incisions combined with interrupted buried suture blepharoplasty: flexible-rigid fixation.

The traditional full incision blepharoplasty is the most commonly used in Asia. However, it has significant drawbacks like long recovery period, excessive surgical marks etc. We offer a new suture idea and combine it with interrupted suture buried blepharoplasty to improve these disadvantages. In our procedure, the orbital septum is opened and separating the levator aponeurosis-the retro-orbital septum complex under this 3-5 millimeters small incision, a flexible-rigid fixation would be made: suture fixation was made to the tarsus-the complex-lower lip orbicularis oculi muscle. We interrupted bury the sutures in the uncut skin between the two small incisions. This paper included 333 patients divided into small incision groups using flexible-rigid fixation (n = 244, 73.3%) and full incision groups using rigid fixation (n = 89, 26.7%). Both at 6-month and at 5-year postoperative follow-up, the satisfaction of small incision group was statistically higher than the full incision group. The overall postoperative complication rate was statistically significantly less in the small incision. The permanence was not statistically different. For Assignment of Postoperative Effort Score (PES) results, at 6 months postoperatively, the mean score was 8.29 ± 1.32 in the small incision group, 7.86 ± 1.54 in the full incision group. At 5 years postoperatively, the mean score was 7.48 ± 1.45 in the small incision group, 7.51 ± 1.73 in the full incision group. None were statistically different. The small incisions group achieves a higher level of patient satisfaction and more mild trauma in the surgical area, has a low complication rate, and a decent degree of durability.

Minimally Invasive Costal Cartilage Harvesting Incision for Chest Deformity in Microtia Reconstruction.

Chest deformity is a potential complication associated with auricular reconstruction using autologous costal cartilage. The impact of the incision size employed for costal cartilage harvesting on chest deformities remains unclear. This study aimed to investigate the correlation between the incision size used for harvesting costal cartilage and the occurrence of chest deformities. We retrospectively analyzed patients who underwent ear reconstruction using autologous costal cartilage between June 2021 and September 2022. The patients were categorized into two groups based on the size of the costal cartilage incision: large and small. Chest computed tomography (CT) was performed 18-24 months postoperatively, followed by three-dimensional color map quantification to assess the degree of asymmetry of the chest surface. Subsequently, quantitative data analysis was performed to compare the extent of chest asymmetry between the large- and small-incision groups. The Visual Analog Scale (VAS) was used to assess patient satisfaction with chest morphology. This study included 62 patients, with an equal distribution of 31 in each group. The mean asymmetry value of the small and large incision groups was -3.15 ± 1.88 and -5.27 ± 3.63, respectively. Moreover, the mean VAS score for the small and large incision groups was 7.48 ± 0.72 and 5.09 ± 0.94, respectively. Statistically significant differences were observed between the two groups. Small incision costal cartilage harvesting can effectively alleviate the severity of chest deformities and significantly enhance patient satisfaction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Evaluation of effects of small-incision approach treatment on proximal tibia fracture by deep learning algorithm-based magnetic resonance imaging.

In this study, magnetic resonance imaging (MRI) based on a deep learning algorithm was used to evaluate the clinical effect of the small-incision approach in treating proximal tibial fractures. Super-resolution reconstruction (SRR) algorithm was used to reconstruct MRI images for analysis and comparison. The research objects were 40 patients with proximal tibial fractures. According to the random number method, patients were divided into a small-incision approach group (22 cases) and an ordinary approach group (18 cases). The peak signal-to-noise ratio (PSNR) and the structural similarity index (SSIM) of the MRI images before and after the reconstruction of the two groups were analyzed. The operative time, intraoperative blood loss, complete weight-bearing time, complete healing time, knee range of motion, and knee function of the two treatments were compared. The results showed that after SRR, the PSNR and SSIM of MRI images were 35.28 and 0.826 dB, respectively, so the MRI image display effect was better. The operation time in the small-incision approach group was 84.93 min, which was significantly shorter than that in the common approach group, and the intraoperative blood loss was 219.95 mL, which was significantly shorter than that in the common approach group (P < 0.05). The complete weight-bearing time and complete healing time in the small-incision approach group were 14.75 and 16.79 weeks, respectively, which were significantly shorter than those in the ordinary approach group (P < 0.05). The half-year knee range of motion and 1-year knee range of motion in the small-incision approach group were 118.27° and 128.72°, respectively, which were significantly higher than those in the conventional approach group (P < 0.05). After 6 months of treatment, the rate of good treatment was 86.36% in the small-incision approach group and 77.78% in the ordinary approach group. After 1 year of treatment, the rate of excellent and good treatment was 90.91% in the small-incision approach group and 83.33% in the ordinary approach group. The rate of good treatment for half a year and 1 year in the small incision group was significantly higher than that in the common approach group (P < 0.05). In conclusion, MRI image based on deep learning algorithm has a high resolution, good display effect, and high application value. The small-incision approach can be applied to the treatment of proximal tibial fractures, which showed good therapeutic effects and a high positive clinical application value.

A study of incidence of dry eye after manual small incision cataract surgery and phacoemulsification

To compare incidence of dry eye between phacoemulsification and manual small incision cataract surgery. This observational study included two groups. Group A consisted of 30 patients who had undergone manual small incision cataract surgery and Group B consisted of 30 patients who had undergone phacoemulsification. A detailed history was taken from all paricipants before they underwent a complete systemic and ocular examination which included best corrected visual acuity, slit lamp examination, intraocular pressure, and dilated fundus examination. Tests for dry eyes likes Schirmer’s test 1, tear film break up time (TBUT), tear meniscus height (TMH) was done postoperatively at 1 week, 3 weeks and 1 month postoperative. One test positive out of three was considered as a dry eye.The values of various tear film tests schirmer’s test, tear film break up time and tear meniscus height showed no significant difference between both groups (Chi square test P Value = 0.605,0.832, 1). There was no significant difference in incidence of dry eye in manual small incision cataract surgery and phacoemulsification (Chi square test p value = 0.317). On comparing the data with respect to age and sex, no significant difference in incidence of dry eye was seen between both groups or between male and female. There is high incidence of dry eye 33.33⸓ seen in diabetic patients. (Chi square test P Value = 0.0371).There is no significant difference in incidence of dry eye between manual small incision cataract surgery and phacoemulsification. We also found out high incidence of dry eye in diabetic patients.

Comparison of the efficacy of small-incision clamp-assisted reduction and open reduction for the treatment of femoral shaft fractures with an anterograde intramedullary nail: a retrospective study

BackgroundTo compare the efficacy of small-incision clamp-assisted reduction with open reduction for the treatment of femoral shaft fractures by anterograde intramedullary nailing.MethodsThe data of 63 patients with femoral shaft fractures, treated between January 2016 and June 2021, were retrospectively analyzed. All patients received anterograde intramedullary nail fixation, and the OA/OTA classification of fractures was 32-C. The average follow-up period was 13 months (range: 11–14 months). According to the method of fracture reduction, patients were divided into a small-incision clamp-reduction group (referred to as the clamp-reduction group) and an open-reduction group. The reduction time, operative time, the number of fluoroscopy, intraoperative blood loss, postoperative VAS score, postoperative time to discharge, and the rates of intraoperative and postoperative complications were compared between the two groups.ResultsThere were statistically significant differences in reduction time, operative time, the number of fluoroscopy, intraoperative blood loss, postoperative VAS score, postoperative time to discharge (t = 6.718, − 11.679, 18.963, − 11.609, − 22.432, − 7.187; P < 0.05). In the clamp-reduction group, there was no intraoperative blood transfusion. However, there were one case of wound infection and one case of deep vein thrombosis after operation. In the open-reduction group, ten patients received intraoperative blood transfusion, one patient developed hemorrhagic shock, two patients developed wound infection, and two patients developed bone nonunion during follow-up.ConclusionsBoth groups had good functional recovery after operation. However, compared with open reduction, clamp reduction is a safer reduction method with shorter operation time, less intraoperative blood loss, less postoperative pain, shorter hospital stay and fewer postoperative complications.

A New Treatment Algorithm That Incorporates Minimally Invasive Surgery for Pyogenic Spondylodiscitis in the Thoracic and Lumbar Spines: The Results of Its Clinical Application to a Series of 34 Patients.

Background and Objectives: Spinal minimally invasive surgery (MIS) experts at the university hospital worked as a team to develop a new treatment algorithm for pyogenic spondylodiscitis in lumbar and thoracic spines. They modified a flow chart introduced for this condition in a pre-MIS era to incorporate MIS techniques based on their extensive experiences accumulated over the years, both in MIS for degenerative lumbar diseases and in the treatment of spine infections. The MIS procedures incorporated in this algorithm consisted of percutaneous pedicle screw (PPS)–rod fixation and transpsoas lateral lumbar interbody fusion (LLIF). The current study analyzed a series of 34 patients treated with prospective selection of the methods according to this new algorithm. Materials and Methods: The algorithm first divided the patients into those who had escaped complicated disease conditions, such as neurologic impairment, extensive bone destruction, and the need to be mobilized without delay (Group 1) (19), and those with complicated pyogenic spondylodiscitis (Group 2) (15). Group 1 had image-guided needle biopsy followed by conservative treatment alone with antibiotics and a spinal brace (12) (Group 1-A) or a subsequent addition of non-fused PPS–rod fixation (7) (Group 1-B). Group 2 underwent an immediate single-stage MIS with non-fused PPS–rod fixation followed by posterior exposure for decompression and debridement through a small midline incision (12) (Group 2-A) or an additional LLIF procedure after an interval of 3 weeks (3) (Group 2-B). Results: All patients, except four, who either died from causes unrelated to the spondylodiscitis (2) or became lost to follow up (2), were cured of infection with normalized CRP at an average follow up of 606 days (105–1522 days). A solid interbody fusion occurred at the affected vertebrae in 15 patients (50%). Of the patients in Group 2, all but two regained a nearly normal function. Despite concerns about non-fused PPS–rod instrumentation, only seven patients (21%) required implant removal or replacement. Conclusions: Non-fused PPS–rod placements into infection-free vertebrae alone or in combination with posterior debridement through a small incision worked effectively in providing local stabilization without contamination of the metal implant from the infected tissue. MIS LLIF allowed for direct access to the infected focus for bone grafting in cases of extensive vertebral body destruction.

The impact of endoscopic sphincterotomy incision size on common bile duct stone recurrence: A propensity score matching analysis.

The aim of this study is to clarify the relation between the incision size for endoscopic sphincterotomy (EST) and common bile duct stone (CBDS) recurrence. Patients who underwent elective endoscopic treatment for CBDS between January 2013 and December 2017 were enrolled, excluding those who met the exclusion criteria. The clinical characteristics were investigated using propensity score matching analysis. A total of 243 patients were investigated. Propensity scores were calculated using multinomial logistic regression with five relevant variables (age, gender, follow-up time, maximum stone size, and bile duct diameter), which led to extraction of 188 cases to compose cohorts of the small and medium EST incision groups. The CBDS recurrence rate was 17.0% in the small incision group and 6.4% in the medium incision group. Multivariate analysis identified the medium incision as an independent predictor of CBDS recurrence (hazard ratio 0.350, 95% confidence interval 0.133-0.922, P=.034). The CBDS non-recurrence rate of the medium incision group was significantly higher than that of the small incision group (log-rank test P=.019). Our findings suggest that the CBDS recurrence rate was lower in EST with medium incision size than with small incision size.

Visual assessment between phacoemulsification and small incision with 5.2mm non-foldable intraocular lens implant.

Objective: To compare visual assessment between phacoemulsification and small incision with 5.2mm non-foldable intraocular lens implant. Study Design: Experiential Study. Setting: Institute of Ophthalmology, Liaquat University Hospital Jamshoro, Period: September 2019 to August 2020. Material &amp; Methods: We performed cataract surgeries using the non-foldable intraocular lens in 100 patients. Two techniques were performed, dividing patients equally into Phaco (Group-A) and SI (Group-B) cataract surgery. The outcomes of both were analyzed uncorrected visual acuity and complications. Results: Of the total 50 patients who underwent phacoemulsification, 55% were male and 45% females in Group-A while Group B (SI surgery) were 45% were male and 35% were female. The intra-operative success rate was 90% in Phaco group and 74% in SI group. In comparison, small Incision group had 10% of patients had difficulty in capsulorhexis, 8% in posterior capsular rupture, 6% in zonular dialysis, 2% iridodialysis, and 0% showing nucleus drip with all complications being higher than in Phaco Group except for nucleus drip (2% vs. 0%). Although, post-operatively, individually groups have similar complications with no notable difference seen, yet astigmatism was lesser in Group A than in Group B. Conclusion: Both techniques showed similar outcomes in the uncorrected visual acuity; however, astigmatism and complication rates were lesser in the phacoemulsification study group.

Analysis of 85 Cases of Minimal Media Lower Hemisternotomy for Congenital Cardiac Surgery Under Cardiopulmonary Bypass in Infants.

To investigate the feasibility and effect of minimal media lower hemisternotomy for cardiac surgery under cardiopulmonary bypass (CPB) in infant congenital heart disease. In our hospital from May 2019 to October 2019, 170 infants with congenital heart disease underwent surgical treatment (median age 6.6 months; weight 6.0 kg). They were divided into 2 groups: those with conventional chest median incision and those with minimal sternotomy. Minimal lower hemisternotomy began from the third intercostal level and ended 0.5 cm above the xiphoid, just enough to insert a small sternal distractor. There was no significant difference between the 2 groups in CPB time. The operation time of small incision group was slightly longer (P < .05). There was no difference in prognosis between the 2 groups, but the wound length of the small incision group was significantly reduced (4.0 ± 0.5 versus 7.8 ± 0.8 cm, P < .05). Time of intensive care unit and hospital stay was shorter among hemisternotomy patients at a statistically significant level (P < .05). Minimal media lower hemisternotomy with the basic advantages of the sternal incision can expose the various parts of the heart, which meets most cardiac exploration and surgical operation needs, and the incision may still be extended if necessary. Lower hemisternotomy appears to be a safe, effective, and versatile alternative for many surgical interventions in infants with congenital heart disease.

Comparison of Classical Open Appendectomy, Small Incision Appendectomy and Laparoscopic Appendectomy in Children with Uncomplicated Acute Appendicitis

Background: The surgical anatomy of appendix coupled with a lax abdominal wall in children creates a possibility of accomplishing an appendectomy using a small incision. The aim of the present study was to compare the outcomes of classical grid iron, small incision and laparoscopic appendectomy in children with uncomplicated acute appendicitis. Method: A prospective comparative study was undertaken at a tertiary care hospital, where patients who underwent either open (classical or small incision) or laparoscopic appendicectomy were studied and compared for various intraoperative and postoperative parameters. The subjects selected for study were children in the age group of 4 – 14 years of age, and were diagnosed as having simple acute appendicitis. Results: Out of a total of 201 patients included in the study; 78 underwent appendectomy by classical Grid iron incision, 62 by small incision and 67 by a conventional laparoscopic method. The baseline parameters were similar in all the three groups. The mean operative time was significantly lower in small incision group. There was no intra-operative complication noticed in any of the groups. Conversions were significantly higher in the small incision group as compared to classical grid iron and laparoscopic approach. The mean pain scores (visual analogue scale) were significantly decreased in the laparoscopic group. The mean hospital stay and return to activities of daily life was significantly increased in the classical grid iron group. Conclusion: Laparoscopic approach for appendectomy seems to be a clear winner in uncomplicated paediatric appendicitis, but small incision approach provides an acceptable alternative, as compared to the standard grid iron incision.

Comparison of visual outcomes in patients undergoing small incision cataract surgery versus phacoemulsification at Divisional Headquarters Hospital, New Mirpur, Azad Kashmir.

Cataract extraction is one of the commonest surgical procedures in Ophthalmology globally. Extracapsular cataract extraction ECCE), through a small incision (SICS), with insertion of an intraocular lens has been the most widely used method from 1990s until recently. Technological advances have led to the increasing use of phacoemulsification (PE) to emulsify and remove the lens. The technique requires a smaller incision, but requires substantial capital investment in theatre equipment. In this we compared the visual outcomes of patients undergoing both surgical techniques at a public sector hospital in Mirpur. Study Design: Single-center retrospective cohort study. Setting: Department of Ophthalmology, Divisional Headquarters Hospital, New Mirpur, AJK. Period: Cataract surgery cases from January 2018 to February 2019. Materials and Methods: 196 patients with age related cataract were included in the SICS group and 115 in the phacoemulsification group. The main comparative outcome was uncorrected visual acuity 4 weeks after surgery. Results: In this study, it was found that the primary post-operative visual outcome for small incision cataract surgery and phacoemulsification was comparable in terms of uncorrected visual acuity. No statistically significant difference was found in the proportions of SICS and phacoemulsification groups when compared for UCVA of 6/9 or better, 6/60 or better and 6/60 and worse.

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

Application of small incision approach in anterior surgery of thoracic and lumbar spinal tuberculosis

To investigate the value of small incision approach in the anterior surgery of thoracic and lumbar spinal tuberculosis. A clinical data of 65 patients with thoracic or lumbar spinal tuberculosis treated with posterior-anterior surgery between January 2015 and January 2018 was retrospectively analyzed. The patients were divided into small incision group (group A, 29 patients) and traditional incision group (group B, 36 patients) according to the length of anterior incision. There was no significant difference in general data such as gender, age, disease duration, segment of lesion, American Spinal Cord Injury Association (ASIA) grading, preoperative pain visual analogue scale (VAS) score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Cobb angle of spinal kyphosis between 2 groups ( P>0.05). The length of anterior incision, operation time, intraoperative blood loss, postoperative complications, postoperative hospitalization time, ESR, and CRP were recorded and compared. The VAS score was used to evaluate the pain after operation. The Cobb angles in patients with spinal kyphosis were measured and the loss of angle and correction rate of angle were calculated. The result of bone graft fusion was assessed according to the Bridwell standard. The length of anterior incision, operation time, intraoperative blood loss, and hospitalization time of group A were all significantly less than those of group B ( P<0.05). All patients in both groups were followed up 12-29 months (mean, 20 months). There were 4 cases (13.8%) and 14 cases (38.9%) of postoperative complications in groups A and B respectively, showing significant difference ( χ 2=5.050, P=0.025). The ESR and CRP in 2 groups all returned to normal at 6 months after operation, and there was no significant difference in ESR and CRP between 2 groups at 3 months, 6 months, and last follow-up ( P>0.05). At last follow-up, the neurological function of patient with neurological symptoms was significantly better than that before operation, and there was no significant difference between 2 groups ( Z=0.167, P=0.868). The VAS scores of 2 groups at each time point after operation were significantly lower than those before operation ( P<0.05); the VAS score in group A was significantly lower than that in group B ( t=-2.317, P=0.024) at 1 day after operation, but there was no significant difference between 2 groups ( t=-0.862, P=0.392) at last follow-up. Among the patients with kyphosis, the Cobb angle was significantly decreased at 1 day after operation and last follow-up when compared with preoperative angle ( P<0.05); but there was no significant difference between 1 day after operation and last follow-up ( P>0.05). There was no significant difference in Cobb angle, loss of angle, and correction rate between 2 groups after operation ( P>0.05). The bone graft healed well at last follow-up in 2 groups. There was no significant difference in bone graft fusion rate between 2 groups at 6 months after operation, 1 year after operation, and last follow-up ( P>0.05). At last follow-up, all patients cured, and no recurrence occurred. In the anterior surgery of thoracic and lumbar tuberculosis, the application of small incision approach can achieve the similar effectiveness as traditional incision surgery with the advantages of minimally invasive, less complications, and quick recovery.

Total arthroscopic internal drainage technique for the treatment of popliteal cyst

To compare the clinical effects of total arthroscopic internal drainage and arthroscopic combined with posterior small incision in the treatment of popliteal cyst. From January 2015 to January 2017, 60 patients with popliteal cyst were treated, including 29 males and 31 females, aged 30 to 65(47.8±2.5) years old, with a course of disease (8.5±4.2) months. Among them, 30 cases received total arthroscopic internal drainage for popliteal fossa cyst(total arthroscopic group), 30 cases received arthroscopic combined with posterior small incision for popliteal fossa cyst(arthroscopic combined with small incision group). The operation time, intraoperative bleeding volume, incision length, Rauschning and Lindgren grade 0 recovery rate and Lysholm score were compared between the two groups. Twenty-nine patients in total arthroscopy group were followed up, and 28 patients in arthroscopy combined with small incision group were followed up for 8 to 20(12.8±2.1) months. Operation time: total arthroscopic group(45.32±5.71) min, arthroscopic combined small incision group (44.56±3.85) min; Rauschning and Lindgren grade 0 recovery: 23 cases in total arthroscopic group, 22 cases in arthroscopic combined small incision group; postoperative Lysholm score: total arthroscopic group 84.5±11.2, arthroscopic combined small incision group 83.2±12.7; there was no significant difference between the two groups(P>0.05). Intraoperative bleeding volume: total arthroscopic group(5.32±1.25) ml, arthroscopic combined small incision group(20.75±8.18) ml; incision length: total arthroscopic group (1.51±0.34) cm, arthroscopic combined small incision group (7.34±0.75) cm; the difference between the two groups was significant(P<0.05). At the last follow-up, the knee joint was examined by magnetic resonance imaging, and no recurrence of cyst was found. Total arthroscopic internal drainage and arthroscopic combined with posterior small incision technique for popliteal fossa cyst with intra-articular lesions have the same clinical effect, but less trauma and faster recovery.

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&#x0D; 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.&#x0D; 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.&#x0D; 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

A comparison of vision outcome and safety between small incision non-phacoemulsification and phacoemulsification surgery for cataract in Tibet

Objective To compare and analyze the visual outcome and safety of phacoemulsification with small incision non-phacoemulsification for cataract and provide a reference for the selection of surgery methods in Tibet. Methods A prospective cohort study was performed.Eighty eyes of 80 consecutive patients with age-related cataract were included in Titet Autonomous Region Tibetan Tradition Medicine Hospital from July to August 2016.The eyes were assigned to non-phacoemulsification extracapsular cataract extraction with small incision combined with intraocular lens (IOL) implantation group (small incision group) and phacoemulsification extracapsular cataract extraction combined with IOL implantation group (phacoemulsification group), with 40 eyes for each group.The uncorrected visual outcome and complications were compared between the two groups after surgery. Results There were no significant differences in gender, age, preoperative visual acuity, and lens nuclear hardness between the two groups (all at P>0.05). The eyes in various post-operative uncorrected visual acuity outcome was not significantly different 1 day and 5 days after surgery between the two groups (both at P>0.05). In the fifth day after surgery, the eye number in various post-operative uncorrected visual acuity outcome was not significantly different in the eyes with grade Ⅱ and Ⅲ nuclei between the two groups (Z=0.503, P=0.478; Z=0.952, P=0.329). The eye number of acuity ≥0.5 in the small incision group was significantly more than that in the phacoemulsification group in the eyes with grade Ⅳ nuclei (Z=4.501, P=0.034). The eye number with post-operative transiently ocular hypertension was increased in small incision group compared with phacoemulsification group. Conclusions Non-phacoemulsification surgery with small incision has comparable visual outcome with phacoemulsification surgery, and small incision non-phacoemulsification surgery combined with IOL implantation can serve as the preferred surgical method in basic level medical institutions of Tibet. Key words: Cataract/surgery; Small incision extracapsular cataract extraction; Phacoemulsification; Tibet; Comparative study

Application effect of three-point small incision in double blepharoplasty

Objective To explore the application effect of three-point small incision in double eyelid plasty. Methods From October 2013 to October 2016, 160 patients with double blepharoplasty in the Central Hospital of Linfen were selected and randomly divided into traditional group(treated with traditional surgery) and small incision group(treated with three-point small incision in double eyelid plasty) according to the digital table, with 80 cases in each group.All patients were followed up for half a year.The pain score at postoperative 24h, wound healing time, swelling regression time, satisfaction score and the incidence of complications were compared between the two groups. Results The pain score at postoperative 24h of the small incision group was (2.75±0.32)points, which was significantly lower than (4.15±0.41)points of the traditional group, and the swelling subsided time, postoperative incision healing time of the small incision group were (4.24±0.41)d, (5.27±0.32)d, respectively, which were significantly shorter than those of the traditional group[(6.12±0.32)d, (8.17±0.45)d], the differences were statistically significant(t=24.076, 32.331, 46.974, all P<0.05). After follow-up for half a year, the satisfaction score of patients in the small incision group was (89.75±4.32)points, which was significantly higher than (82.15±4.10)points of the traditional group, the difference was statistically significant(t=11.413, P<0.05). The incidence rate of complications in the small incision group was 0.00%, which was significantly lower than 7.50% in the traditional group(χ2=6.233, P<0.05). Conclusion The effect of three-point small incision intervention on double eyelid plasty patients is significant, and the satisfaction rate of the patients is higher. Key words: Blepharoplasty; Ophthalmologic surgical procedures; Postoperative complications; Wound healing; Patient satisfaction; Pain; Treatment outcome

Incidence and pattern of dry eye after cataract surgery

PurposeThe objectives of the study were to identify the incidence and pattern of dry eye after phacoemulsification and manual small incision cataract surgeries. MethodsThe study consisted of two groups of patients - Group 1 underwent manual small incision cataract surgery (SICS) and Group 2 underwent phacoemulsification. The dry eye-related data was collected preoperatively and at 1 week, 1 month and 3 months postoperatively. Ocular Surface Disease Index questionnaire, tear break-up time (TBUT) and Schirmer test – 1 were used to record the type of dry eye. ResultsOne hundred eyes of 96 patients, including 35 (36.5%) men and 61 (63.5%) women with the mean age of 63.1 (±8.3) years were studied. Dry eyes were found in 42% eyes (p < 0.001) of patients at 1 week follow-up. Fifteen percent and 9% of the eyes were dry at 1 month and 3 months after surgery, respectively. There were 34 (53.1%) and 8 (22.2%) dry eyes in SICS and phacoemulsification groups, respectively at one week postoperative follow-up which was a statistically significant difference.Majority of eyes (27/42, 64.3%) had mild dryness. There were significant differences in TBUT at 1 week, 1 month and 3 months postoperatively. At 1 week review, the SICS group had mean TUBT of 10.0 (±0.55) sec as compared to 13.9 (±0.70) sec in phacoemulsification group (p < 0.001). ConclusionIncidence of dry eye is higher in SICS than phacoemulsification due to tear film instability. The clinicians should be conscious about dry eye symptoms and signs in an otherwise healthy eye after cataract surgery.

Comparative analysis on the changes of ocular surface and tear film after small incision manual nucleus delivery for cataract with hard nucleus

Objective To compare the effect of small incision manual nucleus delivery and phacoemulsification on ocular surface and tear film for patients with hard nucleus cataract. Methods The clinical data of 60 eyes of 60 patients with hard nucleus cataract were analyzed retrospectively. All patients were randomly divided into small incision group and phacoemulsification group with 30 eyes of 30 cases in each group. The small incision group underwent cataract extraction with small incision manual nucleus delivery. The followed-up time was 3 months. Results The tear river height(TMH) and tear break-up time(BUT) in 1 week and 1 month after surgery were lower than those before surgery (all P<0.05). The corneal fluorescein staining(FS) and questionnaire score were increased in 1 week and 1 month after surgery (P<0.05). The Schirmer I test(SIt) were increased in 1 week after surgery (P<0.05). The score of corneal FS, SIt and questionnaire score in small incision group was significantly higher than those in phacoemulsification group in 1 week after surgery(P<0.05). Conclusion There is great effect of small incision manual nucleus delivery for hard nucleus cataract on ocular surface and tear film at the early stage after surgery, but there is no difference of effect at late stage compared with phacoemulsification. Key words: Cataract, hard nucleus; Small incision manual, nucleus delivery; Dry eye; Tear film

Current Status of Surgical Incisions Used in Donors During Living Related Liver Transplantation-A Nationwide Survey in Japan.

Smaller surgical incisions have recently been introduced in living donor liver procurement. This study used national data from Japan to clarify the present status of surgical incisions in living donor liver procurement. A nationwide, questionnaire-based survey related to 3121 donors and recipients was used. Donors were divided into 2 groups: left lateral segment graft (LLSG) procurement (n = 690) and other types (n = 2431). Incisions were classified into 6 types: type I, upper midline and bilateral subcostal; type II, upper midline and right subcostal; type III, upper midline and right subcostal to the right lateral margin of the abdominal rectus muscle; type IV, upper midline without laparoscopy; type V, upper midline with laparoscopy; and type VI, lower abdominal using the full laparoscopic technique. Types I, II, and III were regarded as standard, and types IV, V, and VI as small incisions. In LLSGs, blood transfusion and postoperative complication rates were significantly less frequent in the small incision group than in the standard group. In other graft types, there were no significant differences in blood transfusion, postoperative complication, and recipients' graft loss rates. The rates of wound extension during surgery were 2.8% and 2.1% in the small incision group in LLSGs and in other graft types, respectively. A small incision was adapted more frequently and postoperative complications were less common in high-volume centers. Various incisions have been adopted in living donor liver procurement. Donor safety and graft integrity appear to have been retained for donors receiving small incisions.