Manual suture less small incision cataract surgery in patients with uveitic cataract

Abstract

Purpose:The purpose of this study is to evaluate the outcome of manual small incision cataract surgery (SICS) in eyes with uveitic cataract.Setting:Medical college hospital of the subcontinent.Design:Retrospective case series.Materials and Methods:In this retrospective study, patients who underwent SICS with posterior chamber intraocular lens implantation for uveitic cataract from 2006 to 2009 were evaluated. Patients with less than 3 months follow-up were excluded. Post-operative vision and complications were analyzed.Results:A total of 54 patients completed the study. The mean age was 52.3 ± 9.3 years. The mean follow-up was 11.53 ± 5.05 months. The mean surgical time was (10.2 ± 3.8 min). Etiological diagnosis was possible in 31.41% (17/54) of patients. There was a statistically significant improvement in vision after surgery (P < 0.001). When uveitis was well-controlled, pre-operative corticosteroids did not change post-operative inflammation (P = 0.796). However, pre-operative corticosteroids were statistically significantly associated to final best corrected visual acuity (BCVA) (P = 0.010).Conclusion:SICS with posterior chamber intraocular lens implantation is safe in most cataracts due to uveitis and improves BCVA at 6 months. Inflammation should be well-controlled pre-operatively for at least 3 months. Posterior capsule opacification, macular edema and persistent uveitis were the main factors affecting visual outcome. SICS requires minimal instrumentation, surgical time is short and can also be performed in rural clinics and eye-camps, where phacoemulsification machines are unavailable. SICS may be a more practical and cost-effective technique for uveitic cataract, in such circumstances.

Phacoemulsification Versus Manual Small Incision Cataract Surgery in Patients With Fuchs Heterochromic Iridocyclitis

“…On the first postoperative day, there were more cases of corneal edema (12,17.1%) in the phacoemulsification group than in the SICS group (8,11.4%) (P = 0.046). The mean endothelial cell loss in these patients was 26.8% at 1 week and 31.4% at 6 months in the phacoemulsification group and 22.7% and 26.4% in the SICS group, respectively.…”

“…It requires minimal instrumentation and can be performed in rural and semirural settings as well. 7,8 However, the safety and efficacy of SICS in FHI has not been established. An extensive review of the literature did not reveal any published randomized controlled trials comparing phacoemulsification and manual SICS for FHI (MEDLINE search).…”

Outcomes of manual small incision cataract surgery (mSICS) compared with phacoemulsification from population based outreach eye camp, in Yogyakarta and Southern Central Java Region, Indonesia

“…The mSICS is preferred option by surgeons and could be performed in rural and semi-urban settings and in eye-camps. 15,16 It is preferred in high volume outreach camp, such as in low socio-economic communities in the developing countries, due to its cost effective, comparable visual outcome, while being non machine dependent. 16 The limitation of the present study was the best corrected visual acuity examination was heavily influenced by the condition of the posterior segment.…”

Comparison of endothelial cell loss and complications between phacoemulsification and manual small incision cataract surgery (SICS) in uveitic cataract

“…There was no significant difference in the rate of postoperative complications between phacoemulsification and manual SICS. In a retrospective study on 53 eyes in patients with uveitis Bhargava et al (2014) found manual SICS to be a safe procedure with predictably good visual outcome. Persistent uveitis, macular edema and PCO were the main factors affecting visual outcome.…”