Aims and objective: To compare surgically induced astigmatism(SIA) in L-shaped vs straight incision in manual small incision cataract surgery(SICS).
Material method: 60 patients aged 35 years and above with uncomplicated cataract with nuclear sclerosis of any grade were included in the study who were divided into 2 groups randomly. 30 patients underwent SICS with straight scleral incision and 30 with L-shaped incision. Data was analyzed using SPSS version 15.0 statistical analysis and calculations were performed using SIA calculator version 2.1.
Results: The SIA (surgically induced astigmatism) was 1.14 ± 0.44D, 0.81 ± 0.40D, 0.61 ± 0.33 D on 1st post-operative day, 4 weeks and 6 weeks respectively in straight incision group and the SIA was 0.79 ± 0.36D, 0.33 ± 0.31D, 0.15 ± 0.18D on 1st post-operative day, 4 weeks and 6 weeks respectively in L-shaped incision group.
Conclusion: L-shaped incision technique induces less amount of SIA as compared to straight incision and the difference is statistically significant. Also, L-shaped incision maintains better anterior chamber stability and leads to early visual rehabilitation. In poor and developing countries where still majority of cases are being operated by manual SICS, achieving emmetropia or minimal refractive errors should be the goal.
ABSTRACT
Purpose: To evaluate the results after frontalis sling surgery in congenital unilateral ptosis.
Methods:
This was a prospective study which included 27 eyes of patients with congenital unilateral ptosis and fair to poor levator action (<8mm). A complete examination was performed including palpebral fissure height and width, lid-crease distance, margin reflex distance 1 (MRD 1) and margin reflex distance 2 (MRD 2), levator function. Fox pentagon technique was employed using silicon rod. Follow up was done at 2 weeks and at 3 months and based on the criteria recommended by Tarbet et al, the ptosis correction was catergorized into: ‘excellent’ if MRD1 measured more than 2mm or the difference in MRD1 between two eyelids was equal to or less than 1 mm, ‘good’ if MRD1 ranged from 1 to 2mm or if asymmetry was 1.5 to 2mm, and ‘poor’ if MRD1 measured less than 1 mm or if asymmetry was greater than 2mm in primary position of gaze.
Results: A total of 27 eyelids of 27 patients underwent frontalis sling surgery with silicon rod. The correction was excellent in 20 patients (74%) on both first and second follow-up visits, shown in fig1. It was good in 5 patients (19%) and poor in 2 patients (7%) based on the above mentioned criteria. Lagophthalmos was present in all patients postoperatively which improved with time.
Conclusion: This study shows that surgical repair using silicone sling is a safe and effective method of correcting congenital ptosis with poor to fair levator function.
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