scholarly journals Evolution of cataract surgery: Smaller incision - less complications

2012 ◽  
Vol 69 (5) ◽  
pp. 385-388 ◽  
Author(s):  
Vladimir Draganic ◽  
Miroslav Vukosavljevic ◽  
Milorad Milivojevic ◽  
Mirko Resan ◽  
Nenad Petrovic

Background/Aim. Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. Methods. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/ forceps IOL implantation, phacoemulsification/ injector IOL implantation, microincision cataract surgery (MICS). Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Results. Uncorrected visual aquity 30 days postoperatively was ? 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS) there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Conclusion. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

2016 ◽  
Vol 9 (3) ◽  
Author(s):  
Mumtaz Hussain ◽  
Muhammad Moin ◽  
Nazir Ahmad Aasi ◽  
Muhammad Waqas ◽  
Jawaid Mughal

The study of 30 patients was performed at Lahore General Hospital, and Institute Of Ophthalmology Mayo Hospital, Lahore from June 1989 to June 2003 for 14 years. Total number of eyes were 34 where 2 patients had both eyes. Age ranged from 12-65 years. Males were 11 and females were 19. all the patients had planned extracapsular cataract extraction with IOL implantation. Total follow up period ranged from 1-5 years and best corrected visual acuity in these patients after surgery was 6/12 to 6/6. Post operatively, eyes had vitreous membranes and glaucomatous reaction.


2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Liuyang Li ◽  
Yan Wang ◽  
Caihong Xue

Purpose. As a secondary analysis, we reassess the association of initial congenital cataract surgery times, compliance to amblyopia therapy, and visual outcomes for a long-term follow-up in a secondary IOL implantation. Methods. Retrospective review of records of all infants with congenital cataracts who underwent secondary IOL implantation in the Eye and ENT Hospital of Fudan University from January 1, 2001, to December 31, 2007, and the minimum follow-up period was 5 years. Multiple regression analysis was used and the possible confounding factors were also analyzed to assess the effect on visual outcome. Results. A total of 110 patients (male: 59.1%) were included. The median (min–max) age at cataract extraction and IOL implantation was 7.5 (3.0–15.0) and 35.0 (22.0–184.0) months, respectively, and the average follow-up period was 99.3 ± 23.6 months. The median (min–max) BCVA at final follow-up was 0.20 (0.01–1.00). Compliance to amblyopia therapy was none, poor, and good in 21.8%, 24.5%, and 53.6%, respectively. Postoperative BCVA [logMAR, median (min–max) 0.70 (0.00–2.00)] linearly decreased with increasing cataract extraction time (per month) (β=0.04, 95% CI: 0.03–0.06, p<0.0001) in multivariable models with laterality and compliance to amblyopia therapy adjusted. Good compliance to amblyopia therapy was associated with better BCVA (logMAR) at last follow-up (β=−0.40, 95% CI = −0.53 to −0.27, p<0.0001) with laterality, opacity type, and extraction time adjusted. Conclusions. For Chinese infants with congenital cataract, an earlier primary congenital cataract surgery at an age of 3 to 15 months is associated with a better visual outcome. Good compliance to amblyopia therapy was also significant to visual outcome.


1969 ◽  
Vol 2 (1) ◽  
pp. 100-104
Author(s):  
Haroon Rashid ◽  
Faizur Rahman ◽  
Sayed Ashfaq Ali Shah ◽  
Muhammad Ali Jan

Objectives: To evaluate the management and visual outcome of cataract surgery in children. Study design: Descriptive. Material and Methods: This study included one hundred pediatric patients having cataracts over a periodof two year, from Is' January 2005 to 31 st December 2006, at the Department of Ophthalmology, SaiduTeaching Hospital, Saidu Sharif, Swat. Results: Age range was fourteen years and below. Sixty five (65%) patients were males and thirty five (35%) females. Sixty three (63%) patients had congenital or developmental cataracts and thirty seven (37%) had traumatic cataracts. Extracapsular cataract extraction (aspiration) was performed on 150 eyes. Postoperative visual acuity was recordable in 112 eyes. Acorrected visual acuity of 6/18 or better was obtained in50 (44.64%) eyes. Forty one (36.6%) eyes obtained visual acuity of 6/24 to 6/60, while in 21 (18.75%) eyesthe visual acuity remained below 6/60. The most common postoperative complication was development ofthick posterior capsule, which occurred in 51 (34%) eyes and vitreous loss in 10 (6.6%) eyes. Pupil blockglaucoma developed in 4 (2.66%) eyes. No case developed endophthalmitis. Posterior chamber IOL wasimplanted in 9 (6%) eyes. Conclusions: Management of cataracts in children is still a problem and delayed presentation leads to poorvisual outcome. The public should be educated to seek early treatment for childhood cataracts. Paramedicsand doctors should be made aware of the problem and its management. Management of unilateral cataractsis still a difficult problem. Therefore search should continue for better surgical approach and better methodsof correction of aphakia so as to achieve better visual outcome. Key words: Childhood Cataracts, Congenital Cataracts and Traumatic Cataracts.


2017 ◽  
Vol 5 (3) ◽  
pp. 1-10
Author(s):  
L R Puri ◽  
G S Shrestha

Trauma is an important cause of monocular blindness in the developing world. This study aims to determine the demo­graphic profile and visual outcome of cataract surgery among the children with traumatic cataract. It was a prospective and longitudinal study of 189 consecutive children below 16 years who underwent cataract surgery with intra ocular lens (IOL) implantation for traumatic cataract at Sagarmatha Choudhary Eye Hospital, Lahan, Nepal from October 2012 to March 2014. Assessment included visual acuity measurement in the Snellen’s chart or the Cardiff card, anterior segment examina­tion with slit lamp, dilated fundus examination with the help of +20D lens in indirect ophthalmoscope, B-scan ultrasonogra­phy of posterior segment and objective and subjective refraction. Follow up was scheduled at first post-operative day, at dis­charge, one month and three months. Cause and type of trauma, demographic factors, surgical intervention, complications, and visual acuity was recorded. Among 189, majority of them were males (73%) and the average age was 8.8±3.6 years. The time of presentation ranged from 3 days to 8 years (median age two months). Wooden stick was the most common cause of injury (34.4%). The average preoperative visual acuity in logMAR scale was 1.6. The average postoperative visual acuity in logMAR scale was 0.8. Eye injuries with traumatic cataract are associated with significant visual impairment. Cataract surgery with intraocular lens implantation restores vision significantly.


2021 ◽  
pp. 46-48
Author(s):  
Nidhi Nidhi ◽  
R. K. Chaurasia ◽  
Jimmy Mittal

PURPOSE: To evaluate efcacy and visual outcome of manual small incision cataract surgery (SICS) and phacoemulsication. METHODS: A prospective, interventional, observational, follow up study was conducted on 120 patients with clinically signicant senile cataract undergoing cataract surgery by either SICS or phacoemulsication, at a tertiary eye care centre in Lucknow. The follow up evaluations were carried out at post-operative day st rd th 1, 1 week, 3 week and 6 week. RESULTS: On rst postoperative day, there was signicantly better visual outcome with phacoemulsication than SICS (p = 0.005) with 80% patients in SICS group and 90% patients in phacoemulsication group, th had best corrected visual acuity (BCVA) better than equal to 6/18. However at 6 week, nal visual recovery was similar in both the groups (BCVA 6/18 in 96.7% in SICS group and 100% in phacoemulsication group) with no statistically signicant difference. There was no signicant difference in overall per operative and post operative complications between SICS and phacoemulsication. SICS and phacoemulsication did not show signicant difference in surgery induced astigmatism (SIA) with SIA of 0.733D and 0.775D in SICS and phacoemulsication group respectively. CONCLUSIONS: Phacoemulsication is superior to SICS in terms of early visual rehabilitation. But there is no signicant difference in nal visual outcome and complication rates between the two techniques.


2021 ◽  
pp. 19-21
Author(s):  
Tammana Jyothirmai ◽  
BNS Rekha ◽  
Maridi Aparna ◽  
Vepa Meenakshi

AIM: To determine the prevalence and visual outcomes after cataract surgery in different LIG patients METHODS:In this prospective study 50 patients were taken into study. Detailed history was taken and slit lamp examination was done & IOP was recorded by AT. All the patients were treated preoperatively appropriately. Patients were operated with SICS with PC IOL implantation and Peripheral Iridectomy.During follow up a detailed Ocular examination was done including Refraction using snellens chart and IOP measurement with AT. RESULTS: Among 50 patients 21(42%)were male patients and 29(58%)were female. Maximum patients had Phacomorphic Glaucoma accounting 72% (36patients) and Phacolytic Glaucoma 24%. Highest percentage was among 40-49mmHg (52%) followed by 30-39mmHg (36%) and >50mmHg (10%). Highest patients were between 10-19mmHg (76%). Visual acuity on admission, highest patients were seen in HM positive (64%) followed by PL+(32%). Even No PL were also seen (4%). On follow up after 6weeks ,majority were seen between 6/12- 6/18(52%) CONCLUSION: LIG is an important vision-threatening disease presenting as a painful red eye. It is remaining as one of the important cause of Blindness not only because of Senile cataract but even after cataract surgery due to Glaucoma caused by neglected cataractous lens.Hence, importance should be given for timely surgery for better visual outcome .


2021 ◽  
pp. 9-11
Author(s):  
Haniyaa Mufti ◽  
Syed Tariq Qureshi ◽  
Tufela Shaf

Purpose: To compare the visual outcome in patients of nucleus drop undergoing same day pars plana vitrectomy (PPV) versus delayed PPV. Methods: A prospective observational study was conducted on 50 eyes with posteriorly dislocated nucleus after cataract surgery who underwent PPV. Study variables included the time duration between nucleus drop and PPV, nal best-corrected visual acuity(BCVA), and complications after PPV. In 7(14%) eyes, PPV was performed on the same day of cataract surgery and in 43(86%) eyes, an elective PPV was performed after 1 week of cataract surgery. All our cases had intraocular lens(IOL) implanted at the end of PPV. Patients were followed up for 6 months with BCVA, intraocular pressure (IOP) measurement, indirect ophthalmoscopy and ocular coherence tomography(OCT).Results: Comparison was made between VA in patients who underwent PPV on same day (n=7) and those who underwent delayed PPV (n=43). In the same day group, 85.71% patients had BCVA ranged between 6/6 to 6/18, while only 14.29% had BCVA between 6/18 to 6/60 at the nal follow up. In the delayed PPV group , 60.47% had BCVA range between 6/6 to 6/18, 27.90% had BCVA ranged between 6/18 to 6/60 and only 11.63% patients had BCVA of <6/60- hand movements (HM) . Pvalue was 0.398 which was not statistically signicant.Conclusion: Majority of the patients obtain good VAafter PPVfor nucleus drop irrespective of the time. The visual outcome in both the groups was comparable, but slightly better results were obtained in the same day PPVgroup.


2000 ◽  
Vol 10 (2) ◽  
pp. 144-148 ◽  
Author(s):  
F. Öztürk ◽  
E. Kurt ◽  
Ü.Ü. Ínan ◽  
S.S. Ílker

Purpose To evaluate the effectiveness of phenylephrine 2.5% and flurbiprofen 0.03% combined in inducing and maintaining mydriasis during extracapsular cataract extraction (ECCE). Methods One hundred patients undergoing ECCE + intraocular lens (IOL) implantation were randomly divided into four groups. The first group was given phenylphrine 10%, the second group phenylephrine 10% + flurbiprofen, the third group phenylephrine 2.5% and fourth group phenylephrine 2.5% + flurbiprofen. Cyclopentolate 1% was used in all patients. Phenylephrine and cyclopentolate were instilled preoperatively four times during 1 hour and flurbiprofen was given four times the day before surgery and twice with an hour's interval before operation. Pre-operative and post-cortex aspiration horizontal pupil diameters were measured with callipers viewed through the operating microscope. Results Pupil diameters in pre-operative and post-cortex aspiration were no different in the 2.5% and 10% phenylephrine groups (p>0.05). Both diameters were larger and pupillary constriction was smaller in the flurbiprofen groups (p<0.05). Conclusions 2.5% phenylephrine was as effective as 10% phenylephrine, with and without flurbiprofen, in inducing and maintaining pupil dilatation during ECCE surgery.


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