Minimal astigmatism after sutureless planned extracapsular cataract extraction
To evaluate astigmatism after mini-nuc extracapsular cataract extraction (ECCE) in which a chevron incision is enlarged to 6.0 to 7.0 mm for easier nucleus removal and to compare the results with those using a 5.0 mm incision.
Department of Ophthalmology, The Edith Wolfson Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Holon, Israel.
Thirty eyes of 29 patients were enrolled in this study. Keratometry was performed preoperatively and 3 to 9 months postoperatively. The incision length was 6.0 mm in 6 eyes, 6.5 mm in 10 eyes, and 7.0 mm in 14 eyes that had mature cataract.
The mean induced astigmatism calculated by simple subtraction was 0.12 diopter (D) +/- 0.51 (SD), 0.16 +/- 0.98 D, and 0.67 +/- 0.91 D for the 6.0 mm, 6.5 mm, and 7.0 mm incision, respectively. By vector analysis, the mean induced astigmatism was 0.60 +/- 0.30 D, 0.75 +/- 0.67 D, and 1.36 +/- 0.77 D, respectively. Results by both methods showed no significant difference between the previously reported 5.0 mm incision and the 6.0 mm and 6.5 mm incisions. The 7.0 mm group had statistically significantly greater induced astigmatism than the 5.0 mm group (P =.01, simple subtraction; P =.002, vector analysis).
Enlarging the size of the chevron incision up to 7.0 mm resulted in a small increase in induced astigmatism. The enlarged incision simplified the operative technique.
Available from: nepjol.info
- "Manual SICS is an alternative for phacoemulsification but the astigmatism is higher due to the larger size of incision. Burgansky et al have shown an increase in astigmatism with an increase in incision size (Burgansky et al, 2002). In their study by vector analysis, the mean induced astigmatism was 0.6 + 0.3 D for 6 mm incision, 0.75 + 0.67 D for a 6.5 mm incision and 1.36 + 0.77 D for a 7 mm incision. "
[Show abstract] [Hide abstract]
ABSTRACT: Introduction: Now-a-days, all techniques of cataract extraction are meant for giving the best uncorrected visual acuity and early post-operative rehabilitation. Purpose: To compare astigmatism induced by the superior and temporal section in manual small incision cataract surgery (SICS) in the Indian population. Materials and methods: One hundred and ten eyes were taken. Eyes having a steeper vertical keratometry reading were assigned to the superior SICS group whereas eyes with a steeper horizontal keratometry reading were assigned to the temporal SICS group. Eyes with no astigmatism were randomly assigned to either of the two groups. Both the groups had 54 eyes each. Eyes in Group 1 underwent manual SICS with a superior tunnel and eyes in Group 2 underwent manual SICS with a temporal tunnel. The patients were examined on postopera- tive Day1, 1 week, 45 days, and 3 months. Uncorrected and best-corrected visual acuity was recorded, slit-lamp examination, auto-refracto-meter and keratometry examinations were done. Statistics: All calculations were performed using surgically-induced astigmatism (SIA) Calculator version 1.0, a free software program. Results: In Group 2, only 35 eyes out of 54 completed the follow-up of 90 days. The mean SIA in Group1 was found to be 1.45 +/- 0.7387 and in Group 2 it was 0.75+/- 0.4067. The z score applied was found to be 5.7143. This value was more than the standard value, i.e.2.58. The p value accordingly was less than 0.001, which is highly significant. The SIA induced by the superior incision was 48.28 % more than by the temporal incision. Conclusion: SICS with the temporal approach provides a better stabilization of the refraction with a significantly less SIA than superior approach.
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH 02/2012; 4(7):54-8. DOI:10.3126/nepjoph.v4i1.5851
Available from: ayubmed.edu.pk
[Show abstract] [Hide abstract]
ABSTRACT: To evaluate the changes in Preoperative and Postoperative keratometry results and rapid visual rehabilitation in Cataract surgery by our phaco-sandwich technique through the self sealing sclero-corneal tunnel incision without phacoemulsification.
96 eyes of 88 patients with age-related cataracts underwent small incision suture less cataract surgery without phacoemulsification. All eyes were operated by the phaco-sandwich technique through sclerocorneal tunnel with 6 mm frown-shaped external scleral incision. 6 mm single piece PMMA lens was implanted in the capsular bag. Patients were evaluated at 1 week, 4 weeks and 12 weeks post-operatively.
Ninety six eyes of eighty eight patients were our cohort. During the first post-operative week 8 eyes (8.3%) had uncorrected visual acuity (UCVA) of 6/6. By the end of 12 post-operative weeks, 33 eyes (34.5%) had UCVA of 6/6. 64 (66.7%), 72 (75%) and 80 (83.3%) eyes had best correctable visual acuity (BCVA) of 6/6 after 4 weeks, 8 weeks and 12 weeks respectively. 64 (66.7%) eyes after 4 weeks, 72 (75%) after 8 weeks and 80 (83%) after 12 weeks had best correctable visual acuity (BCVA) of 6/6.
Suture less, small-incision cataract surgery is an economical, safe and effective method of managing cataract cases. This technique also ensures satisfactory and rapid rehabilitation for patients. This procedure can be effectively applied to clear the backlog of cataract-related blindness in places wherein the resources for phaco facilities are not available.
Journal of Ayub Medical College, Abbottabad: JAMC 18(4):53-7.
Available from: Berkant Kaderli
[Show abstract] [Hide abstract]
ABSTRACT: To determine whether deep-topical anesthesia is suitable for small-incision manual extracapsular cataract extraction (ECCE).
Three hundred twenty-six eyes of 253 patients had small-incision manual ECCE under topical anesthesia with a 4% lidocaine-soaked sponge. The severity of the pain, eye movements, blepharospasm, and intraoperative complications were recorded. Patient and surgeon satisfaction levels were assessed.
Operations on 323 eyes (99%) were completed with topical anesthesia. Intraoperatively, topical anesthesia was converted to peribulbar anesthesia in 3 eyes (0.9%) because of excessive eye movements. The cauterization of the scleral vessels and conjunctiva and the subconjunctival injection were the stages causing severe pain. The most frequent intraoperative complication was posterior capsule rupture in 6 eyes (1.8%). The satisfaction level was 95% for the patients and 90% for the surgeon.
Deep-topical, nerve-block anesthesia provides anesthesia with sufficient quality for small-incision manual ECCE.
Ophthalmic Surgery Lasers and Imaging 11/2004; 35(6):460-4. · 1.32 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.