scholarly journals Impact of Ophthalmic Viscosurgical Devices in Cataract Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-17
Author(s):  
Monali S. Malvankar-Mehta ◽  
Angel Fu ◽  
Yasoda Subramanian ◽  
Cindy Hutnik
Keyword(s):  
Cataract Surgery ◽  
Meta Analysis ◽  
Grey Literature ◽  
Database Search ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Soft Shell ◽  
Standardized Mean Difference

Background. Ophthalmic viscoelastic devices (OVDs) used during small-incision cataract surgery have numerous advantages. However, OVDs have longer retention time in an eye after surgery resulting in intraocular pressure (IOP) spikes. The purpose of this study is to analyze and quantify the effect of various OVDs on both IOP and best corrected visual acuity (BCVA) by systematically reviewing the literature and performing meta-analysis. Methods. Numerous databases from January 1, 1985, to present were systematically searched. Thirty-six (3893 subjects) of 3313 studies identified were included for analysis. Standardized mean difference (SMD) was computed, and meta-analysis was performed. Results. A total of 3313 records were retrieved including 1114 from database search and 2199 from grey literature search. Significant increase in postoperative IOP in 1-day follow-up with Healon (SMD = 0.37, CI: [0.07, 0.67]), Viscoat (SMD = 0.29, CI: [0.13, 0.45]), Provisc (SMD = 0.46, CI: [0.17, 0.76]), and Soft Shell (SMD = 0.58, CI: [0.30, 0.86]) was computed. On the other hand, results implied a nonsignificant increase in postoperative IOP with Healon GV (SMD = 0.07, CI: [−0.28, 0.41]), Healon5 (SMD = 0.15, CI: [−0.33, 0.64]), 2% HPMC (SMD = 0.32, CI: [−0.0, 0.64]), and OcuCoat (SMD = 0.26, CI: [−0.37, 0.9]). Additionally, a nonsignificant reduction in postoperative IOP was inferred with Viscoat + Provisc (SMD = −0.28, CI: [−2.23, 1.68]). Conclusion. Improvement in IOP was shown with Viscoat + Provisc. Additionally, IOP nonsignificant upsurge was observed with Healon GV, Healon5, 2% HPMC, and OcuCoat compared to significant upsurge with Healon, Viscoat, and Soft Shell.

scholarly journals Sub-conjunctival dislocation of posterior chamber intra-ocular lens: five years after manual, small-incision cataract surgery

2014 ◽  
Vol 6 (1) ◽  
pp. 91-94
Author(s):  
Rajesh Subhash Joshi
Keyword(s):  
Cataract Surgery ◽  
Wound Closure ◽  
Wound Dehiscence ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Scleral Tunnel ◽  
Posterior Chamber Intraocular Lens

Introduction: Ocular trauma can cause serious complications in eyes operated for cataract. Case: A 70-year- old lady had sustained blunt trauma to the left lower lid which resulted in a sub-conjunctival dislocation of the posterior chamber intraocular lens (PCIOL). The patient had undergone an uneventful manual, small-incision, sutureless cataract surgery with implantation of a PCIOL for senile cataract five years ago in the same eye. She had no ocular or systemic predisposing factors for wound dehiscence. Surgical exploration revealed a scleral rupture 7 mm in length, 2 mm behind the limbus at the 12’O clock position along the surgically-constructed wound. However, the scleral tunnel was not damaged. The PCIOL was removed. Wound closure was done to avoid infection of the intraocular structures. Her best-corrected visual acuity was 20/60 at the three months’ follow-up. Conclusion: Surgeons should be aware of such complications occurring due to trauma. We recommend suturing of the scleral wound to strengthen it in cases of a deep scleral groove or when there is a possibility of a premature entry of the wound into the anterior chamber. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10777   Nepal J Ophthalmol 2014; 6 (2): 91-94

scholarly journals Study of Intraoperative Complications in Small Incision Cataract Surgery, its Management and Visual Outcome

2016 ◽  
Vol 3 (1) ◽  
pp. 52 ◽  
Author(s):  
Mrunal Suresh Patil ◽  
Dhiraj Namdeo Balwir ◽  
Sonal Dua
Keyword(s):  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Visual Outcome ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Study Results ◽  
The Common ◽  
Iris Prolapse

Aims: To study the intraoperative complications in small incision cataract surgery and its management and to study the visual outcome following the management of intraoperative complications. Material and Methods: A total of 250 cases studied from who underwent SICS. Intraoperative complications were studied and managed. Visual outcome following these complications were studied by noting the best corrected visual acuity after day 1, 1<sup>st</sup> week, 3<sup>rd</sup> week, 6<sup>th</sup> week following surgery. Results: The total intraoperative complications were seen in 22 (8.8%) patients. Posterior capsule rent was seen in 6 eyes (2.4%). Iris prolapse in 5 eyes (2%). Descemet detachment was seen in 3 eyes (1.2%). Premature entry was seen in 3 eyes (1.2%). Capsulorrhexis extension was seen in 2 eyes (0.8%). Zonular dialysis was seen in 2 eyes (0.8%). Superior iridodialysis was seen in only one eye (0.4%). Out of 250 cases, 246 came for follow up till 6th week. 214 (85.6%) patients had post operative BCVA 6/6 at the end of 6<sup>th</sup> week, 25(10%) patients had 6/9, 5 patients (2%) had 6/12-6/18 and remaining 2 patients (0.8%) had 6/24-6/36 BCVA. Conclusion: The study results shows that in high quality cataract surgery (91.2% without intraoperative complications) 99% BCVA 6/18 or better can be attained. In our study incidence of intraoperative complications was 8.8% in which posterior capsular rent and iris prolapse were the common intraoperative complications.

scholarly journals Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Cataract Surgery ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

scholarly journals Sumbawanga Augencamp follow-up Studie 2019

2019 ◽  
Vol 117 (7) ◽  
pp. 671-676
Author(s):  
S. Irle ◽  
E. Msigomba ◽  
K. Paust
Keyword(s):  
Cataract Surgery ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Therapeutische Möglichkeiten

Zusammenfassung Hintergrund Im Jahr 2019 hat das deutsche Komitee zur Verhütung von Blindheit (DKVB) ein Augencamp in der tansanischen Stadt Sumbawanga durchgeführt. Bei Patienten mit maturer Katarakt und intakter Lichtscheinwahrnehmung wurden Katarakte als „manual small incision cataract surgery“ (MSICS) operiert. Erstmalig wurde bei diesem Camp die Ergebnisqualität der durchgeführten Kataraktoperationen gemessen. Ziel der Arbeit Ziel war es, die Qualität der durchgeführten Kataraktoperationen darzustellen und die Ergebnisse in Zusammenhang mit den Vorgaben der Weltgesundheitsorganisation (WHO) zu bewerten. Methoden Patienten, die in den ersten Tagen des Augencamps kataraktoperiert worden waren, wurden in der zweiten Woche im Hinblick auf die Parameter Visus, Refraktion, spaltlampenmikroskopischer Befund und Komplikationen nachuntersucht, die Daten retrospektiv ausgewertet. Die Ergebnisse wurden mit den Vorgaben der WHO verglichen. Ergebnisse Es konnten 42 Patienten des Augencamps nach 5 bis 9 Tagen nachuntersucht werden. Folgende Parameter wurden gefunden: mittlere postoperative Sehschärfe 0,26, sphärisches Äquivalent −2,82 dpt, Astigmatismus −2,2 dpt/113 Grad; Visus >0,3 in 14,2% (WHO 80%), Visus 0,1–0,3 62% (WHO 15%), Visus <0,1 in 23,8% (WHO 5%); verzögerter Heilungsverlauf in 29% der Fälle. Schlussfolgerung Obwohl es zu einer Besserung des Sehvermögens kam, sind die Ergebnisse ernüchternd im Vergleich zu den Vorgaben der WHO. Postoperativ zeigen sich ein myoper Shift und ein Astigmatismus gegen die Regel. Die Gründe sind: okuläre Komorbiditäten, eingeschränkte diagnostische und therapeutische Möglichkeiten, Ausbildungscharakter des Camps, erschwerte Rahmenbedingungen und fortgeschrittene Befunde. Die Ergebnisse der Studie sind wichtig, um die Qualität der eigenen Arbeit einschätzen zu können und um das Potenzial für künftige Verbesserungen ausloten zu können.

scholarly journals Comparison of endothelial cell loss and complications between phacoemulsification and manual small incision cataract surgery (SICS) in uveitic cataract

2016 ◽  
Vol 7 (2) ◽  
pp. 124-134
Author(s):  
Rahul Bhargava ◽  
Shiv Kumar Sharma ◽  
Mini Chandra ◽  
Prachi Kumar ◽  
Yogesh Arora
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Cell Loss ◽  
Complication Rates ◽  
Endothelial Cell Loss ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Cell Counts ◽  
Endothelial Cell Counts

Introduction: Endothelial cell loss and complications after cataract surgery may be higher when cataract is complicated by uveitis.Objective: To compare endothelial cell damage and complication rates after phacoemulsification and manual small incision cataract surgery (SICS) in patients with uveitis.Materials and methods: Patients with uveitic cataract were randomly allocated for phacoemulsification (n=75) or manual SICS (n=80) in a double blind prospective study. In the bag implantation of a hydrophobic acrylic intraocular lens was aimed in all cases. Patients with follow up of less than six months were excluded. Main outcome measures were alteration in endothelial cell counts (ECC) and morphology, improvement in vision and complication rates. ECC was measured preoperatively and at 1 week, 3 months and six months, postoperatively.Results: Six patients were lost to follow up and another three due inability to implant IOL. There were no significant difference in endothelial cell counts (P= 0.032), the variance of endothelial cell size (CV) and percentage of hexagonal cells between both the groups at six months (Mann-Whitney test, P=0.283). Endothelial cell density was significantly less in the group in which vitrectomy and/or pupil dilatation procedures were performed (2290±31.5 cells/mm2) versus (2385±50.3 cells/mm2), respectively (t test, P<0.001). Incidence of postoperative complications that were observed like persistent uveitis (P=0.591), macular edema (P=0.671) and PCO (P=0.678) and visual outcome (P=0.974) were comparable between the two groups.Conclusions: Manual SICS and phacoemulsification do not differ significantly in endothelial cell loss and complication rates in uveitic eyes. However, increased anterior chamber manoeuvring due to additional procedures may lead to significantly higher endothelial cell loss.

scholarly journals Correlation between visual acuity at discharge and on final follow-up in patients undergoing manual small incision cataract surgery

2021 ◽  
Vol 69 (3) ◽  
pp. 586
Author(s):  
Anika Amritanand ◽  
DeepthiE Kurian ◽  
Monseena Mathew ◽  
Mable Keziah ◽  
Grace Rebekah
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Small Incision Cataract Surgery ◽  
Small Incision
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