Objective:To analyze the efficacy of ultrasonic emulsification and small incision cataract extracapsular extraction in cataract patients.Methods:96 cataract patients admitted from May 2021 to May 2023 were selected an...Objective:To analyze the efficacy of ultrasonic emulsification and small incision cataract extracapsular extraction in cataract patients.Methods:96 cataract patients admitted from May 2021 to May 2023 were selected and randomly grouped into group A(ultrasonic emulsification)and group B(small-incision extracapsular cataract extraction),with 48 cases each.Results:At 1 week,1-month,and 3 months post-operation,the visual acuity of group A was higher and the astigmatism value was lower than that of group B(P<0.05);at 12h,24h,and 48h post-operation,the intraocular pressure of group A was higher than that of group B(P<0.05);the thickness of macular area of group A was lower than that of group B at 1 week and 1-month post-operation(P<0.05).Conclusion:Ultrasonic emulsification in cataract patients was slightly better than small incision cataract extracapsular extraction in correcting astigmatism,improving visual acuity,and regulating macular thickness.However,due to the high energy of ultrasonic emulsification,the risk of complications such as high postoperative intraocular pressure was higher.Small-incision extracapsular cataract extraction has better application value in economically disadvantaged areas.展开更多
Purpose:.To investigate the occurrence of corneal incision-induced astigmatism following small incision extracapsular cataract extraction through a superotemporal incision combined with intraocular lens (IOL) implanta...Purpose:.To investigate the occurrence of corneal incision-induced astigmatism following small incision extracapsular cataract extraction through a superotemporal incision combined with intraocular lens (IOL) implantation. Methods:.A total of 255 cases (301 eyes) who received small incision extracapsular cataract extraction through a superotemporal incision with IOL implantation in the Department of Ophthalmology, Yuyan District Hospital of Guiyang were enrolled in this clinical trial..Postoperative best-corrected visual acuity and astigmatism were measured. The patients underwent 24-week follow-up. Results: In total, 166 patients (65.1%, 166 eyes) completed follow-up..Astigmatism gradually declined between 1 and 12-week postoperatively, and stabilized after 12 weeks. Among 166 patients,.125(75.3%).had astigmatism > 0.5 D at 24 weeks post-operatively,.showing mostly with-the-rule astigmatism. Visual acuity steadily improved up to 12 weeks, and tended to stabilize subsequently..Over the period of 24-week postoperatively,.visual acuity was negatively correlated with astigmatism (r=-0.691,P<0.05). Conclusion:Superotemporal small incision extracapsular extraction combined with IOL implantation is associated with modest astigmatism which declines over the post-operative period.展开更多
AIMTo compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic cataract.METHODSIn a prospective, randomized multi-centric study, consecutive patients w...AIMTo compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic cataract.METHODSIn a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI). A P value of <0.05 was considered statistically significant.RESULTSOne hundred and twenty-six of 139 patients (90.6%) completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1) or inability implant an intraocular lens (IOL) because of insufficient capsular support following posterior capsule rupture (n=5). There was significant improvement in vision after both the procedures (paired t-test; P<0.001). On first postoperative day, uncorrected distance visual acuity (UDVA) was 20/63 or better in 31 (47%) patients in Phaco group and 26 (43.3%) patients in SICS group (P=0.384). The mean surgically induced astigmatism (SIA) was 0.86±0.34 dioptres (D) in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002). At 6mo, corrected distance visual acuity (CDVA) was 20/60 or better in 60 (90.9%) patients in Phaco group and 53 (88.3%) in the manual SICS group (P=0.478). The mean surgical time was significantly shorter in the manual SICS group (10.8±2.9 versus 13.2±2.6min) (P<0.001). Oral prednisolone, 1 mg/kg body weight was given 7d prior to surgery, continued post-operatively and tapered according to the inflammatory response over 4-6wk in patients with previously documented macular edema, recurrent uveitis, chronic anterior uveitis and intermediate uveitis. Rate of complications like macular edema (Chi-square, P=0.459), persistent uveitis (Chi-square, P=0.289) and posterior capsule opacification (Chi-square, P=0.474) were comparable between both the groups.CONCLUSIONManual SICS and phacoemulsification do not differ significantly in complication rates and final CDVA outcomes. However, manual SICS is significantly faster. It may be the preferred technique in settings where surgical volume is high and access to phacoemulsification is limited, such as in eye camps. It may also be the appropriate technique for uveitic cataract under such circumstances.展开更多
AIM: To evaluate the effects and safety of phacoemulsification (Phaco) or small-incision extracapsular cataract surgery (SICS) and intraocular lens (IOL) implantation for aged patients. METHODS: Totally 137 aged patie...AIM: To evaluate the effects and safety of phacoemulsification (Phaco) or small-incision extracapsular cataract surgery (SICS) and intraocular lens (IOL) implantation for aged patients. METHODS: Totally 137 aged patients (149 eyes) underwent cataract operation in the case of stable systemic condition, the blood pressure less than 160/95mmHg, blood glucose less than 8mmol/L, and under the help of electrocardiogram surveillance by anesthesiologists during the operation. 106 aged patients (114 eyes) underwent Phaco while 31 aged patients (35 eyes) underwent SICS. The postoperative visual acuity, corneal endothelial cell loss, surgery time and major complications were observed and analyzed retrospectively. RESULTS: The best-corrected visual acuity (BCVA) of >= 0.6 was achieved in 135 eyes (92.6%) at 1 month postoperatively (chi(2)=259.730, P<0.001). For aged patients, both Phaco and SICS could significantly improve visual acuity with no significant difference (chi(2)=4.535, P > 0.05). Postoperative corneal endothelial cell loss was 18.6%, in PHACO group, the rate was 18.5%; in SICS group, the rate was 19.0%, the difference of which was no significant (chi(2)=0.102, P>0.05). The surgery time was different in two groups. No severe complications occurred. CONCLUSION: Both Phaco and SICS combined with IOL implantation for aged patients are effective and safe. Before surgery, detailed physical examination should be performed. When the systemic condition is stable, cataract surgery for aged patients is safe.展开更多
AIMTo determine the surgically induced astigmatism (SIA) in Straight, Frown and Inverted V shape (Chevron) incisions in manual small incision cataract surgery (SICS).
AIM: To report the long-term outcomes of combined excisional goniotomy and manual small incision cataract surgery(MSICS).METHODS: This is a retrospective case series of patients with open angle glaucoma and visually s...AIM: To report the long-term outcomes of combined excisional goniotomy and manual small incision cataract surgery(MSICS).METHODS: This is a retrospective case series of patients with open angle glaucoma and visually significant cataracts that underwent combined excisional goniotomy and MSICS with one-year follow-up. The medical history, demographic information, and clinical characteristics of each case were recorded. Data regarding changes in vision, intraocular pressure(IOP), the number of glaucoma medications, and the evolution of the disease after surgery were reported. RESULTS: Three patients, with open angle glaucoma and cataracts underwent combined excisional goniotomy and MSICS without adverse events. All patients had improvement in vision compared to baseline measurements. The range of IOP at baseline was from 14 to 18 mm Hg and decrease to a range of 10 to 14 mm Hg after one year of follow-up. Additionally, two patients also decreased their dependence on IOP-lowering medications at the last follow up visit with one patient maintaining baseline level of medication use.CONCLUSION: A combination of excisional goniotomy and MSICS illustrates both the safety and efficacy to treat patients with visually significant cataract and glaucoma. This procedure allows for a more cost-effective surgical approach that matches the needs of resource strained territories around the globe.展开更多
Dear Sir,It is known that cataract surgery is challenging in vitrectomized eyes.Cataract surgeons may have encountered with posterior capsular complications and nucleus drop events even with minimal ocular manipulatio...Dear Sir,It is known that cataract surgery is challenging in vitrectomized eyes.Cataract surgeons may have encountered with posterior capsular complications and nucleus drop events even with minimal ocular manipulations and low irrigation bottle height.Inadvertent damage to the zonular fibers,posterior or peripheral lens capsule with ocutome or microvitreoretinal(MVR)blade in previous展开更多
AIM:To compare the efficacy and visual results of the modified Blumenthal and Ruit techniques for manual small-incision cataract surgery(MSICS).· METHODS:This was a prospective,non-randomized comparison of 129 pa...AIM:To compare the efficacy and visual results of the modified Blumenthal and Ruit techniques for manual small-incision cataract surgery(MSICS).· METHODS:This was a prospective,non-randomized comparison of 129 patients with senile cataracts scheduled to undergo routine cataract surgery via either a superior scleral tunnel incision,i.e.,the Blumenthal technique(group 1,n = 64) or a temporal scleral tunnel incision,i.e.,the Ruit technique(group 2,n =65).MSICS and intraocular lens implantation were performed through an unsutured 6.5-to 7.0-mm scleral tunnel incision.Uncorrected and corrected visual acuity,intraoperative and postoperative complications,and surgically induced astigmatism calculated by simple subtraction were compared.Patients were examined at 1 day,1 week,1 month,and 3 months after surgery.· RESULTS:Both groups achieved good visual outcome with minor complications.Three months after surgery,the corrected visual acuity was 0.73 in the Blumenthal group and 0.69 in the Ruit group(P =0.29).The average(SD) postoperative astigmatism was 0.87(0.62) diopter(D) for the Blumenthal group and 0.86(0.62) D for the Ruit group.The mean(SD) surgically induced astigmatism was 0.55(0.45) D and 0.50(0.44) D for the Blumenthal and Ruit groups,respectively(P =0.52).Common complications were minimal hyphema and corneal edema.There was no statistically significant difference in the complication rate between the groups(P >0.05).· CONCLUSION:In MSICS,both the Blumenthal and Ruit techniques achieved good visual outcomes,with low complication rates.展开更多
We compared surgically induced astigmatism (SIA) by a superior incision with a temporal incision in manual small incision cataract surgery (MSICS), in patients with bilateral direct (regular) preoperative corneal asti...We compared surgically induced astigmatism (SIA) by a superior incision with a temporal incision in manual small incision cataract surgery (MSICS), in patients with bilateral direct (regular) preoperative corneal astigmatisms. Patients and method: We carried out a prospective study from July 1st 2018 to September 30th 2019 in the department of ophthalmology at the University Hospital of Brazzaville. Keratometric readings were recorded before surgery to assess preoperative corneal astigmatisms. Keratometric evaluation was done 45 days post-operatively. Patients were followed 90 days after surgery in order to assess the healing of the surgical site. The surgically induced astigmatism (SIA) is the difference in the magnitude vectors between the preoperative and postoperative astigmatism. The result was positive if the postoperative astigmatism was greater than the preoperative astigmatism and negative if the postoperative astigmatism was less than the preoperative astigmatism. Results: Our study sample included 48 eyes from 24 patients, including 24 operated on temporal incision and 24 in superior incision. The average SIA for superior incisions was 0.33 ± 1.55 diopters (D), versus 0.33 ± 1.44 for temporal incisions. For superior incisions the SIA was 0.81 for astigmatisms lower than 2D, against 0.16D for the temporal incisions. On the other hand, for preoperative astigmatisms greater than 2D, the surgically induced astigmatism was ±0.62D, marking a decrease in preoperative astigmatism for the superior incisions against an increase of 0.5D for the temporal incisions. The healing was delayed for the temporal incisions responsible for discomfort persisting beyond 45 days. Conclusion: The temporal incision had better results than the superior incision for astigmatisms lower than 2D, and less good for astigmatisms higher than 2D. The temporal incision healed less well.展开更多
Background: To investigate early change of corneal aberrations after 2.8-mm superior incision phacoemulsification.Methods: This study comprised 80 eyes of 75 patients. All the patients underwent phacoemulsification wi...Background: To investigate early change of corneal aberrations after 2.8-mm superior incision phacoemulsification.Methods: This study comprised 80 eyes of 75 patients. All the patients underwent phacoemulsification with monofocal foldable intraocular lens(IOLs) implanted through a 2.8-mm superior corneal incision. The anterior corneal wavefront aberrations for the 6.0-mm pupillary diameter was measured by i Trace wavefront aberrometer(Tracey Technologies, Inc.) preoperatively and 1 month postoperatively. Changes of root mean square(RMS) values of Z(3,-3), Z(3, 3), Z(3,-1), Z(3, 1), and Z(4, 0) and total high order aberration(HOA) were evaluated.Results: The uncorrected and corrected visual acuities improve significantly(P<0.001). No significant postoperative changes were observed in spherical aberration(P=0.652). Significant changes in vertical coma and vertical trefoil(0.005±0.214 vs.-0.049±0.242, P=0.037;-0.141±0.222 vs.-0.258±0.359, P=0.001; separately). However, the total HOAs increased after cataract surgery(0.567±0.161 vs. 0.688±0.343, P<0.001).Conclusions: Corneal vertical coma and vertical trefoil changes significantly in 2.8mm superior corneal incision phacoemulsification cataract surgery. In addition, those had a trend to negative direction.展开更多
AIM: To evaluate the visual outcome and factors influencing visual outcome of manual small incision cataract surgery(MSICS) in the rural area in the Xianfeng County.METHODS: Eighty-two eyes of 82 patients who underwen...AIM: To evaluate the visual outcome and factors influencing visual outcome of manual small incision cataract surgery(MSICS) in the rural area in the Xianfeng County.METHODS: Eighty-two eyes of 82 patients who underwent cataract surgery performed by using MSICS technique were identified. Data collected included each patient’s age, gender, the level of education. Uncorrected and corrected distance visual acuity(UDVA and CDVA) at presentation and at 1, 6, 8wk postoperatively, pre-existing eye disease, operative findings and complications, the risk factors were evaluated.RESULTS: In 82 patients, the average age was 69.6±0.6y, illiterate were 52(63.4%). Of 82 eyes, pseudophakia was present in 77 eyes(93.9%). At 1wk postoperatively,47 eyes(57.3%) had the UDVA of ≥6/18, and 52 eyes(63.4%) had the CDVA of ≥6/18. At 6 to 8wk postoperatively, 50 eyes(61.0%) had UDVA of ≥6/18, and57 eyes(69.5%) had the CDVA of ≥6/18. Postoperative visual status was significantly related to the co-morbidities, such as corneal pathology, glaucoma(P 【0.001).Operative complications, such as posterior capsule opacity and cystoid macular edema were main operative cause for the poor visual outcome.CONCLUSION: MSICS provides a good visual recovery in our study but the vision outcome did not fulfill the standards proposed by WHO, which highlights the need for an improvement in local socioeconomic understanding, population education and surgery quality.展开更多
Introduction: Cataract surgery has undergone many changes with the size of incision progressively decreasing over time with an incision of 12.0 mm for intracapsular cataract extraction to 2.2 - 2.8 mm in phacoemulsifi...Introduction: Cataract surgery has undergone many changes with the size of incision progressively decreasing over time with an incision of 12.0 mm for intracapsular cataract extraction to 2.2 - 2.8 mm in phacoemulsification. However, phacoemulsification due to high cost and equipment maintenance cannot be employed widely in developing countries. The phacoalternative or Manual small-incision cataract surgery (MSICS) offers similar advantages with the merits of wider applicability, less time consuming, a shorter learning curve, and lower cost. Haven’t not being without complications like any other surgery We have identified the factors influencing the outcome of phacoalternative cataract surgery in order to improve our quality of care for our patients suffering from blindness induced by the world’s first leading cause of legal blindness. We have identified the factors influencing the outcome of cataract surgery. Patients and Methods: This was a prospective observational study of the descriptive type lasting six (6) months from March 1 to August 30, 2020 including all patients operated on for cataracts and having lower visual acuity at 3/10. The operating form included demographic data, the patient’s personal ophthalmological history, postoperative visual acuity, per and postoperative complications and the type of pathology involved. The analysis was carried out using epi-info 7.2.0.1 software. Results: During this study period, we collected 61 cases of failure of cataract surgery out of a total of 1182 operated eyes, i.e. a frequency of 5.16%. Women represented more than half of the sample with 74%. Almost all of our patients, i.e. 96.72%, were over the age of 60. Loss of visual acuity was the main complaint in all our patients, i.e. 100% followed by photophobia with 24.4% of cases. Arterial hypertension present in 8.20% of patients was the most common comorbidity in our series followed by diabetes with 4.92%. 18 patients (29.5%) presented early postoperative complications such as corneal edema in 15 patients (24.6%) and hyphema in 3 patients (4.9%). Late postoperative complications were dominated by capsular fibrosis encountered in 42.89% of our patients. The causes of failure after cataract surgery were dominated by selection errors which accounted for 36.06% followed by late postoperative complications 34.43%. Conclusion: Like any surgery, cataract surgery can often be marred by various complications often occurring during the intraoperative or postoperative period. These complications in addition to negligence and/or non-deep analysis of certain cases (selection) are often associated with poor functional recovery.展开更多
Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral...Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral flap incision was used in the extracapsular cataract extraction with intraocular lens implantation and the postoperative changes in conreal astigmatism was observed.Results:The peak value of postoperative corneal astigmatism was3.60D,and the corneal astigmatism regression was 2.11D,surgically induced astigmatism was less significant in modified scleral flap incision group than that in convention-al limbal incison group(P<0.05).Conclusions:The modified scleral flap inciston is an ideal incision for cataract ex-traction with intraocular lens implantation when phacoemulsifier is not avaliable.Eye Science1995;11:136-139.展开更多
文摘Objective:To analyze the efficacy of ultrasonic emulsification and small incision cataract extracapsular extraction in cataract patients.Methods:96 cataract patients admitted from May 2021 to May 2023 were selected and randomly grouped into group A(ultrasonic emulsification)and group B(small-incision extracapsular cataract extraction),with 48 cases each.Results:At 1 week,1-month,and 3 months post-operation,the visual acuity of group A was higher and the astigmatism value was lower than that of group B(P<0.05);at 12h,24h,and 48h post-operation,the intraocular pressure of group A was higher than that of group B(P<0.05);the thickness of macular area of group A was lower than that of group B at 1 week and 1-month post-operation(P<0.05).Conclusion:Ultrasonic emulsification in cataract patients was slightly better than small incision cataract extracapsular extraction in correcting astigmatism,improving visual acuity,and regulating macular thickness.However,due to the high energy of ultrasonic emulsification,the risk of complications such as high postoperative intraocular pressure was higher.Small-incision extracapsular cataract extraction has better application value in economically disadvantaged areas.
文摘Purpose:.To investigate the occurrence of corneal incision-induced astigmatism following small incision extracapsular cataract extraction through a superotemporal incision combined with intraocular lens (IOL) implantation. Methods:.A total of 255 cases (301 eyes) who received small incision extracapsular cataract extraction through a superotemporal incision with IOL implantation in the Department of Ophthalmology, Yuyan District Hospital of Guiyang were enrolled in this clinical trial..Postoperative best-corrected visual acuity and astigmatism were measured. The patients underwent 24-week follow-up. Results: In total, 166 patients (65.1%, 166 eyes) completed follow-up..Astigmatism gradually declined between 1 and 12-week postoperatively, and stabilized after 12 weeks. Among 166 patients,.125(75.3%).had astigmatism > 0.5 D at 24 weeks post-operatively,.showing mostly with-the-rule astigmatism. Visual acuity steadily improved up to 12 weeks, and tended to stabilize subsequently..Over the period of 24-week postoperatively,.visual acuity was negatively correlated with astigmatism (r=-0.691,P<0.05). Conclusion:Superotemporal small incision extracapsular extraction combined with IOL implantation is associated with modest astigmatism which declines over the post-operative period.
文摘AIMTo compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic cataract.METHODSIn a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI). A P value of <0.05 was considered statistically significant.RESULTSOne hundred and twenty-six of 139 patients (90.6%) completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1) or inability implant an intraocular lens (IOL) because of insufficient capsular support following posterior capsule rupture (n=5). There was significant improvement in vision after both the procedures (paired t-test; P<0.001). On first postoperative day, uncorrected distance visual acuity (UDVA) was 20/63 or better in 31 (47%) patients in Phaco group and 26 (43.3%) patients in SICS group (P=0.384). The mean surgically induced astigmatism (SIA) was 0.86±0.34 dioptres (D) in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002). At 6mo, corrected distance visual acuity (CDVA) was 20/60 or better in 60 (90.9%) patients in Phaco group and 53 (88.3%) in the manual SICS group (P=0.478). The mean surgical time was significantly shorter in the manual SICS group (10.8±2.9 versus 13.2±2.6min) (P<0.001). Oral prednisolone, 1 mg/kg body weight was given 7d prior to surgery, continued post-operatively and tapered according to the inflammatory response over 4-6wk in patients with previously documented macular edema, recurrent uveitis, chronic anterior uveitis and intermediate uveitis. Rate of complications like macular edema (Chi-square, P=0.459), persistent uveitis (Chi-square, P=0.289) and posterior capsule opacification (Chi-square, P=0.474) were comparable between both the groups.CONCLUSIONManual SICS and phacoemulsification do not differ significantly in complication rates and final CDVA outcomes. However, manual SICS is significantly faster. It may be the preferred technique in settings where surgical volume is high and access to phacoemulsification is limited, such as in eye camps. It may also be the appropriate technique for uveitic cataract under such circumstances.
文摘AIM: To evaluate the effects and safety of phacoemulsification (Phaco) or small-incision extracapsular cataract surgery (SICS) and intraocular lens (IOL) implantation for aged patients. METHODS: Totally 137 aged patients (149 eyes) underwent cataract operation in the case of stable systemic condition, the blood pressure less than 160/95mmHg, blood glucose less than 8mmol/L, and under the help of electrocardiogram surveillance by anesthesiologists during the operation. 106 aged patients (114 eyes) underwent Phaco while 31 aged patients (35 eyes) underwent SICS. The postoperative visual acuity, corneal endothelial cell loss, surgery time and major complications were observed and analyzed retrospectively. RESULTS: The best-corrected visual acuity (BCVA) of >= 0.6 was achieved in 135 eyes (92.6%) at 1 month postoperatively (chi(2)=259.730, P<0.001). For aged patients, both Phaco and SICS could significantly improve visual acuity with no significant difference (chi(2)=4.535, P > 0.05). Postoperative corneal endothelial cell loss was 18.6%, in PHACO group, the rate was 18.5%; in SICS group, the rate was 19.0%, the difference of which was no significant (chi(2)=0.102, P>0.05). The surgery time was different in two groups. No severe complications occurred. CONCLUSION: Both Phaco and SICS combined with IOL implantation for aged patients are effective and safe. Before surgery, detailed physical examination should be performed. When the systemic condition is stable, cataract surgery for aged patients is safe.
文摘AIMTo determine the surgically induced astigmatism (SIA) in Straight, Frown and Inverted V shape (Chevron) incisions in manual small incision cataract surgery (SICS).
文摘AIM: To report the long-term outcomes of combined excisional goniotomy and manual small incision cataract surgery(MSICS).METHODS: This is a retrospective case series of patients with open angle glaucoma and visually significant cataracts that underwent combined excisional goniotomy and MSICS with one-year follow-up. The medical history, demographic information, and clinical characteristics of each case were recorded. Data regarding changes in vision, intraocular pressure(IOP), the number of glaucoma medications, and the evolution of the disease after surgery were reported. RESULTS: Three patients, with open angle glaucoma and cataracts underwent combined excisional goniotomy and MSICS without adverse events. All patients had improvement in vision compared to baseline measurements. The range of IOP at baseline was from 14 to 18 mm Hg and decrease to a range of 10 to 14 mm Hg after one year of follow-up. Additionally, two patients also decreased their dependence on IOP-lowering medications at the last follow up visit with one patient maintaining baseline level of medication use.CONCLUSION: A combination of excisional goniotomy and MSICS illustrates both the safety and efficacy to treat patients with visually significant cataract and glaucoma. This procedure allows for a more cost-effective surgical approach that matches the needs of resource strained territories around the globe.
文摘Dear Sir,It is known that cataract surgery is challenging in vitrectomized eyes.Cataract surgeons may have encountered with posterior capsular complications and nucleus drop events even with minimal ocular manipulations and low irrigation bottle height.Inadvertent damage to the zonular fibers,posterior or peripheral lens capsule with ocutome or microvitreoretinal(MVR)blade in previous
基金Supported by Research and Developmental Fund, Prapokklao Hospital (No.0011)
文摘AIM:To compare the efficacy and visual results of the modified Blumenthal and Ruit techniques for manual small-incision cataract surgery(MSICS).· METHODS:This was a prospective,non-randomized comparison of 129 patients with senile cataracts scheduled to undergo routine cataract surgery via either a superior scleral tunnel incision,i.e.,the Blumenthal technique(group 1,n = 64) or a temporal scleral tunnel incision,i.e.,the Ruit technique(group 2,n =65).MSICS and intraocular lens implantation were performed through an unsutured 6.5-to 7.0-mm scleral tunnel incision.Uncorrected and corrected visual acuity,intraoperative and postoperative complications,and surgically induced astigmatism calculated by simple subtraction were compared.Patients were examined at 1 day,1 week,1 month,and 3 months after surgery.· RESULTS:Both groups achieved good visual outcome with minor complications.Three months after surgery,the corrected visual acuity was 0.73 in the Blumenthal group and 0.69 in the Ruit group(P =0.29).The average(SD) postoperative astigmatism was 0.87(0.62) diopter(D) for the Blumenthal group and 0.86(0.62) D for the Ruit group.The mean(SD) surgically induced astigmatism was 0.55(0.45) D and 0.50(0.44) D for the Blumenthal and Ruit groups,respectively(P =0.52).Common complications were minimal hyphema and corneal edema.There was no statistically significant difference in the complication rate between the groups(P >0.05).· CONCLUSION:In MSICS,both the Blumenthal and Ruit techniques achieved good visual outcomes,with low complication rates.
文摘We compared surgically induced astigmatism (SIA) by a superior incision with a temporal incision in manual small incision cataract surgery (MSICS), in patients with bilateral direct (regular) preoperative corneal astigmatisms. Patients and method: We carried out a prospective study from July 1st 2018 to September 30th 2019 in the department of ophthalmology at the University Hospital of Brazzaville. Keratometric readings were recorded before surgery to assess preoperative corneal astigmatisms. Keratometric evaluation was done 45 days post-operatively. Patients were followed 90 days after surgery in order to assess the healing of the surgical site. The surgically induced astigmatism (SIA) is the difference in the magnitude vectors between the preoperative and postoperative astigmatism. The result was positive if the postoperative astigmatism was greater than the preoperative astigmatism and negative if the postoperative astigmatism was less than the preoperative astigmatism. Results: Our study sample included 48 eyes from 24 patients, including 24 operated on temporal incision and 24 in superior incision. The average SIA for superior incisions was 0.33 ± 1.55 diopters (D), versus 0.33 ± 1.44 for temporal incisions. For superior incisions the SIA was 0.81 for astigmatisms lower than 2D, against 0.16D for the temporal incisions. On the other hand, for preoperative astigmatisms greater than 2D, the surgically induced astigmatism was ±0.62D, marking a decrease in preoperative astigmatism for the superior incisions against an increase of 0.5D for the temporal incisions. The healing was delayed for the temporal incisions responsible for discomfort persisting beyond 45 days. Conclusion: The temporal incision had better results than the superior incision for astigmatisms lower than 2D, and less good for astigmatisms higher than 2D. The temporal incision healed less well.
文摘Background: To investigate early change of corneal aberrations after 2.8-mm superior incision phacoemulsification.Methods: This study comprised 80 eyes of 75 patients. All the patients underwent phacoemulsification with monofocal foldable intraocular lens(IOLs) implanted through a 2.8-mm superior corneal incision. The anterior corneal wavefront aberrations for the 6.0-mm pupillary diameter was measured by i Trace wavefront aberrometer(Tracey Technologies, Inc.) preoperatively and 1 month postoperatively. Changes of root mean square(RMS) values of Z(3,-3), Z(3, 3), Z(3,-1), Z(3, 1), and Z(4, 0) and total high order aberration(HOA) were evaluated.Results: The uncorrected and corrected visual acuities improve significantly(P<0.001). No significant postoperative changes were observed in spherical aberration(P=0.652). Significant changes in vertical coma and vertical trefoil(0.005±0.214 vs.-0.049±0.242, P=0.037;-0.141±0.222 vs.-0.258±0.359, P=0.001; separately). However, the total HOAs increased after cataract surgery(0.567±0.161 vs. 0.688±0.343, P<0.001).Conclusions: Corneal vertical coma and vertical trefoil changes significantly in 2.8mm superior corneal incision phacoemulsification cataract surgery. In addition, those had a trend to negative direction.
基金Supported by National Natural Science Fundation of China(No.81100664)Wuhan Science and Technology Dawn Project(No.2014070404010222)+2 种基金Wuhan University Independent Research Project(No.2042014kf0259)Open Project of the State Key Laboratory of OphthalmologyZhongshan Ophthalmic Center(No.303060202400306)
文摘AIM: To evaluate the visual outcome and factors influencing visual outcome of manual small incision cataract surgery(MSICS) in the rural area in the Xianfeng County.METHODS: Eighty-two eyes of 82 patients who underwent cataract surgery performed by using MSICS technique were identified. Data collected included each patient’s age, gender, the level of education. Uncorrected and corrected distance visual acuity(UDVA and CDVA) at presentation and at 1, 6, 8wk postoperatively, pre-existing eye disease, operative findings and complications, the risk factors were evaluated.RESULTS: In 82 patients, the average age was 69.6±0.6y, illiterate were 52(63.4%). Of 82 eyes, pseudophakia was present in 77 eyes(93.9%). At 1wk postoperatively,47 eyes(57.3%) had the UDVA of ≥6/18, and 52 eyes(63.4%) had the CDVA of ≥6/18. At 6 to 8wk postoperatively, 50 eyes(61.0%) had UDVA of ≥6/18, and57 eyes(69.5%) had the CDVA of ≥6/18. Postoperative visual status was significantly related to the co-morbidities, such as corneal pathology, glaucoma(P 【0.001).Operative complications, such as posterior capsule opacity and cystoid macular edema were main operative cause for the poor visual outcome.CONCLUSION: MSICS provides a good visual recovery in our study but the vision outcome did not fulfill the standards proposed by WHO, which highlights the need for an improvement in local socioeconomic understanding, population education and surgery quality.
文摘Introduction: Cataract surgery has undergone many changes with the size of incision progressively decreasing over time with an incision of 12.0 mm for intracapsular cataract extraction to 2.2 - 2.8 mm in phacoemulsification. However, phacoemulsification due to high cost and equipment maintenance cannot be employed widely in developing countries. The phacoalternative or Manual small-incision cataract surgery (MSICS) offers similar advantages with the merits of wider applicability, less time consuming, a shorter learning curve, and lower cost. Haven’t not being without complications like any other surgery We have identified the factors influencing the outcome of phacoalternative cataract surgery in order to improve our quality of care for our patients suffering from blindness induced by the world’s first leading cause of legal blindness. We have identified the factors influencing the outcome of cataract surgery. Patients and Methods: This was a prospective observational study of the descriptive type lasting six (6) months from March 1 to August 30, 2020 including all patients operated on for cataracts and having lower visual acuity at 3/10. The operating form included demographic data, the patient’s personal ophthalmological history, postoperative visual acuity, per and postoperative complications and the type of pathology involved. The analysis was carried out using epi-info 7.2.0.1 software. Results: During this study period, we collected 61 cases of failure of cataract surgery out of a total of 1182 operated eyes, i.e. a frequency of 5.16%. Women represented more than half of the sample with 74%. Almost all of our patients, i.e. 96.72%, were over the age of 60. Loss of visual acuity was the main complaint in all our patients, i.e. 100% followed by photophobia with 24.4% of cases. Arterial hypertension present in 8.20% of patients was the most common comorbidity in our series followed by diabetes with 4.92%. 18 patients (29.5%) presented early postoperative complications such as corneal edema in 15 patients (24.6%) and hyphema in 3 patients (4.9%). Late postoperative complications were dominated by capsular fibrosis encountered in 42.89% of our patients. The causes of failure after cataract surgery were dominated by selection errors which accounted for 36.06% followed by late postoperative complications 34.43%. Conclusion: Like any surgery, cataract surgery can often be marred by various complications often occurring during the intraoperative or postoperative period. These complications in addition to negligence and/or non-deep analysis of certain cases (selection) are often associated with poor functional recovery.
文摘Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral flap incision was used in the extracapsular cataract extraction with intraocular lens implantation and the postoperative changes in conreal astigmatism was observed.Results:The peak value of postoperative corneal astigmatism was3.60D,and the corneal astigmatism regression was 2.11D,surgically induced astigmatism was less significant in modified scleral flap incision group than that in convention-al limbal incison group(P<0.05).Conclusions:The modified scleral flap inciston is an ideal incision for cataract ex-traction with intraocular lens implantation when phacoemulsifier is not avaliable.Eye Science1995;11:136-139.