A study of evaluation of anterior segment changes in eyes with pseudo exfoliation syndrome including anterior chamber depth status of lens anterior chamber angle preoperatively

2021 ◽  
Vol 19 (3) ◽  
pp. 38-44
Author(s):  
Girish Surlikar ◽  

Background: Pseudoexfoliation syndrome is an important ocular manifestation of a systemic disease, found to be common in cataract patients as well as in 50% of glaucoma patients. Present study was intended to assess the profile of Pseudoexfoliation syndrome and evaluate the surgical outcome of Manual Small Incision Cataract Surgery in Pseudoexfoliative eyes. Material and Methods: Present study was prospective, observational, hospital-based study, conducted in patients with age more than 50 years, with Pseudoexfoliation, admitted for cataract surgery, posted for Manual Small incision cataract surgery(MSICS). All patients underwent a manual small incision cataract surgery, and visual outcomes of the procedures were recorded on the first postoperative day. Results: In present study, maximum numbers of patients were from the age group of 70-79 years (62.5%) and 56 (70%) patients were males and 24 (30%) were females. In this study of 80 patients with Pseudoexfoliation Syndrome, 60 patients had Bilateral Pseudoexfoliation i.e. 120 eyes (85.71%) while 20 patients had Unilateral Pseudoexfoliation i.e. 20 eyes (14.29%). In majority of the eyes 111 (79.29%) had involvement of lens with Pseudoexfoliation while 109 (77.86%) had pupillary involvement. Mean Anterior Chamber Depth in Pseudoexfoliative eyes was 2.50±0.22 mm. Majority of the eyes i.e. 74 (52.9%) were having IOP between 16 – 20 mm Hg. 61 eyes (43.6%) had IOP between 11 – 15 mm Hg. 80 eyes of 80 patients underwent MSICS, 17 (21.25%) patients developed Intraoperative Complications. Conclusion: There is significant association between Pseudoexfoliation syndrome and age, male preponderance and bilateral involvement of eyes. MSICS provides significant improvement in visual outcome in patients with Pseudoexfoliation syndrome with cataract.

Author(s):  
Shams Mohammad Noman ◽  
M. A. Karim

Aim: To evaluate the visual outcome after manual small incision cataract surgery (MSICS) as a treatment of phacolytic glaucoma. Methods: The study included 43 patients with phacolytic glaucoma treated by manual small incision cataract surgery with intraocular lens implantation. Preoperative and postoperative visual acuity and intraocular pressure have been recorded and compared at the end of six weeks after surgery. Results: The mean preoperative intraocular pressure was 36.23 (± 10.86) mm of Hg. There were no significant intraoperative complications such as posterior capsular tear or expulsive hemorrhage. Post operative mean intraocular pressure (IOP) was 12.58 (± 3.45) mm Hg. Pre operative visual acuity in all the affected eyes were perception of light with projection of rays in all quadrant. Postoperative best corrected visual acuity was 6/6-6/18 in 27 patients (62.80%), 6/24- 6/36 in 10 patients (23.25%) and ≤ 6/60 in 6 patients (13.95%). Conclusion: Manual small incision cataract surgery is a safe and effective method of treatment for phacolytic glaucoma and the visual outcome and IOP reduction is satisfactory.


2022 ◽  
Vol 19 (1) ◽  
pp. 64-68
Author(s):  
Bikram Bahadur Thapa ◽  
Basu Prasad Adhikari ◽  
Nanda Kumari Gurung ◽  
Jitendra Kumar Verma

Introduction: Proper preoperative biometry in cataract surgery provides expected postoperative uncorrected visual outcome. Astigmatism is one of the major problems to achieve best postoperative unaided visual acuity. Aims: To determine the distribution of biometric parameter and unaided visual outcome in the cataract patients operated at Nepalgunj medical college, Banke, Nepal. Methods: The patients who underwent cataract surgery between January 2019 and December 2020 at Nepalgunj medical college were studied. Patient’s demographic parameter, keratometric value, anterior chamber depth, lens thickness and axial length data, type of surgery, preoperative and post-operative visual acuity and other clinical details were collected and analyzed. Results: This study enrolled 261 eyes of 261 patients who had undergone cataract surgery. The mean age of patients was 60.8 ± 14.62 years. The mean corneal astigmatism was 1.30±1.43 D. Corneal astigmatism was higher than 1.00 D in almost 40% of cases. With-therule astigmatism was the most common type (46.4%) of astigmatism observed in this study. The mean average keratometry was 44.83±2.05 D. The mean preoperative LogMAR VA of 1.52±0.83 improved to 0.48 ± 0.48 postoperatively without statistically significant differences between manual small incision cataract surgery and phacoemulsification technique (p=0.496). Conclusion: The biometric data helps to improve surgical procedure and select most appropriate intraocular lens to attain maximal postoperative uncorrected visual acuity following cataract surgery. This study found superior convention incision is better for cataract surgery with equivalent visual outcome following manual small incision cataract surgery and phacoemulsification.


2020 ◽  
Vol 12 ◽  
pp. 251584142097737
Author(s):  
Darren S. J. Ting ◽  
Daniel Chua ◽  
Khin Oo May ◽  
Mya Aung ◽  
Ashish Kumar ◽  
...  

Purpose: To present the technique and outcomes of a modified manual small incision cataract surgery designed for the phacoemulsification surgeons who are learning to perform manual small incision cataract surgery. Methods: This was a retrospective, single-centred, comparative study. We included all the patients who underwent the modified manual small incision cataract surgery for visually significant cataract at Singapore National Eye Centre. All surgeries were performed by either a senior phaco-trained surgeon (M.A.) who had performed more than 500 manual small incision cataract surgery or a junior phaco-trained surgeon (D.C.) who had performed around 500 phacoemulsification but never performed any manual small incision cataract surgery. The main modification of this technique lies in the creation of an additional phaco-like main wound at 90° to the scleral tunnel wound, with most surgical steps performed through this additional wound. The outcomes were analysed and compared between the senior and junior surgeons. The main outcome measures were visual outcome and major intraoperative complications such as posterior capsular rupture and zonular dialysis. Results: A total of 132 cases were included; 102 (77.3%) and 30 (22.7%) cases were performed by the senior and junior surgeons, respectively. Pre-operatively, 85.6% eyes had best-corrected visual acuity of counting fingers or worse. Postoperatively, the visual outcome at 1 month was similar between the senior and junior surgeons, with 68.7% eyes achieving a best-corrected visual acuity of ⩾6/12 ( p = 0.17). No posterior capsular rupture, zonular dialysis or endophthalmitis was observed during the study period. Conclusions: This modified technique may serve as a useful transition technique for the phaco-trained surgeons to develop skills in manual small incision cataract surgery, with demonstrable good visual outcome and safety.


2016 ◽  
Vol 3 (1) ◽  
pp. 52 ◽  
Author(s):  
Mrunal Suresh Patil ◽  
Dhiraj Namdeo Balwir ◽  
Sonal Dua

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.


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