Comment on: Outcomes of manual small incision cataract surgery in hypermature morgagnian cataract

Gurnani, Bharat; Kaur, Kirandeep

doi:10.1097/j.jcrs.0000000000001077

Cited by 3 publications

(3 citation statements)

References 4 publications

(3 reference statements)

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“…MSICS is still the surgery of choice in high volume cataract settings in low- and middle-income countries (LMICs). 50 Because of the lacking data, not even a single of the 38 studies is focused on MSICS. This lack of datasets and studies poses a challenge for algorithms development tailored to MSICS scenarios where performance evaluation and recognition is especially important due to higher chances of complications.…”

Section: Discussionmentioning

confidence: 99%

Artificial Intelligence in Cataract Surgery: A Systematic Review

Müller,

Jain,

Sachdeva

et al. 2024

Trans. Vis. Sci. Tech.

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Purpose The purpose of this study was to assess the current use and reliability of artificial intelligence (AI)-based algorithms for analyzing cataract surgery videos. Methods A systematic review of the literature about intra-operative analysis of cataract surgery videos with machine learning techniques was performed. Cataract diagnosis and detection algorithms were excluded. Resulting algorithms were compared, descriptively analyzed, and metrics summarized or visually reported. The reproducibility and reliability of the methods and results were assessed using a modified version of the Medical Image Computing and Computer-Assisted (MICCAI) checklist. Results Thirty-eight of the 550 screened studies were included, 20 addressed the challenge of instrument detection or tracking, 9 focused on phase discrimination, and 8 predicted skill and complications. Instrument detection achieves an area under the receiver operator characteristic curve (ROC AUC) between 0.976 and 0.998, instrument tracking an mAP between 0.685 and 0.929, phase recognition an ROC AUC between 0.773 and 0.990, and complications or surgical skill performs with an ROC AUC between 0.570 and 0.970. Conclusions The studies showed a wide variation in quality and pose a challenge regarding replication due to a small number of public datasets (none for manual small incision cataract surgery) and seldom published source code. There is no standard for reported outcome metrics and validation of the models on external datasets is rare making comparisons difficult. The data suggests that tracking of instruments and phase detection work well but surgical skill and complication recognition remains a challenge for deep learning. Translational Relevance This overview of cataract surgery analysis with AI models provides translational value for improving training of the clinician by identifying successes and challenges.

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Section: Discussionmentioning

confidence: 99%

Artificial Intelligence in Cataract Surgery: A Systematic Review

Müller,

Jain,

Sachdeva

et al. 2024

Trans. Vis. Sci. Tech.

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“…MSICS has been anessential tool in high-volume surgical setup and complex case scenarios to eliminate needless blindness. [ 66 67 ]…”

Section: Future Of Manual Small-incision Cataract Surgerymentioning

confidence: 99%

Evolution of manual small-incision cataract surgery from 8 mm to 2 mm - A comprehensive review

Gurnani

Mishra

Kaur

et al. 2022

Indian Journal of Ophthalmology

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Cataract is the most common cause of reversible blindness worldwide, accounting for approximately 50% of blindness worldwide. Cataract surgery is the most common surgical procedure performed in routine ophthalmic practice. It has undergone tremendous evolution, and the incision size has progressively reduced from 10–12 mm in extracapsular cataract surgery (ECCE) to 6–8 mm for manual small-incision cataract surgery (MSICS) and 2.2–2.8 mm in phacoemulsification. In a developing country like India, with a massive backlog of cataract, everyone cannot afford private surgery like phacoemulsification. Moreover, annual maintenance of the machine, cost of foldable IOLs, need for greater skill, learning curve, and difficulty in performing the surgery in mature and brown cataracts are other barriers. Due to these factors, MSICS is the surgery of choice in the developing world, with profound societal and economic benefits and similar visual recovery compared to phacoemulsification. During the last two decades, MSICS gained popularity in developing countries and has undergone tremendous advances. This article aims to review the various techniques of MSICS and how the surgery has evolved over the years, particularly focusing on the current technique of 2-mm MSICS.

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“…In addition, the most important factors for a good paracentesis creation are the depth and location of the incision. [ 2 ] In our experience, too anterior paracentesis (in the cornea) can result in Descemet membrane detachment (DMD), will not allow the paracentesis to seal adequately, and may require a 10-0 nylon suture at the side port. Next is the depth of the paracentesis.…”

mentioning

confidence: 99%