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

Bhargava, Rahul; Kumar, Pardeep; Sharma, Shiv K.; Arora, Yogesh

doi:10.1097/apo.0000000000000191

Cited by 19 publications

(25 citation statements)

References 18 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, where evidence is available, studies report a high rate of additional procedures, notably intraoperative iris hook use between 19% and 67%, but a low risk of intraoperative complications 6 13 15. The largest of these studies reported no posterior capsular ruptures in any of 171 uveitic eyes undergoing surgery 6…”

Section: Discussionmentioning

confidence: 99%

Cataract surgery in uveitis: a multicentre database study

Chu

Dick

Johnston³

et al. 2017

Br J Ophthalmol

View full text Add to dashboard Cite

SUBTITLE (35 words):Demographics, surgical factors and outcomes from 1173 eyes with uveitis undergoing cataract surgery were compared to control eyes using electronic medical records, which highlighted the increased complexity and management requirements of this patient group. AUTHORS: CORRESPONDING AUTHOR:Alastair K Denniston (Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. a.denniston@bham.ac.uk) KEYWORDS:Uveitis, cataract, phacoemulsification, real-world, database. WORD COUNT: (2866 post-revision) in main text STRUCTURED ABSTRACT (250 words): "Background/aims"Cataract is an important source of visual loss in patients with uveitis. Whether or not outcomes of cataract surgery in eyes with uveitis are worse compared to non-uveitic eyes have to date been compromised by lack of reliable estimates of benefit and harm, which require data from large cohorts. "Methods"Electronic medical record data were extracted from eight independent UK clinical sites for eyes undergoing cataract extraction between January 2010 and December 2014. 1173 eyes with a recorded diagnosis of uveitis were compared to a reference group of 95573 eyes from the same dataset. "Results"Uveitic eyes represented 1.2% of all eyes undergoing cataract surgery. Eyes in the uveitic group had worse pre-operative visual acuity (0.87 vs 0.65 logMAR units), were from younger patients and had shorter axial lengths and a higher incidence of ocular co-pathology including glaucoma. A greater number had documented small pupils, required additional surgical procedures, developed more intraoperative complications and had poorer post-operative visual acuity at all timepoints measured up to 6 months (0.41 vs 0.27 logMAR units at 12-24 weeks). "Conclusion"This large study cohort of eyes with a diagnosis of uveitis undergoing cataract surgery highlights more precisely the complex surgical demands, co-pathology and worse visual outcomes in this group. This data will allow more accurate pre-operative counselling and planning. Although improvement in visual acuity is achieved in most cases, prognosis should be guarded so patient expectations are met. Compared to the non-uveitic population, the mean post-operative visual acuity is between one to two lines worse at all time-points. INTRODUCTION:Cataract is a major cause of visual loss in patients with uveitis; up to 40% of the visual loss is either solely or largely due to cataract [1]. Surgical treatment may be effective but is associated with higher complication rates than in eyes without previous uveitis. Quantifying this risk is important in order to inform patients and surgeons as to the likely short-and long-term benefit or harm of undertaking cataract surgery, and may affect the timing of such surgery.Currently most data on cataract surgery in patients with uveitis comes from small case series or cohort studies, with data gathered over long time periods to attain sufficient numbers. As this may be so long that practice changes, the studies may not reflect current prac...

show abstract

Section: Discussionmentioning

confidence: 99%

Cataract surgery in uveitis: a multicentre database study

Chu

Dick

Johnston³

et al. 2017

Br J Ophthalmol

View full text Add to dashboard Cite

show abstract

“…However, MSICS was a much faster and preferred technique due to its easy accessibility in places such as eye camps. 15 MSICS has proven to be a much cheaper option as compared to Phacoemulsification as it requires lesser equipment and proves to have lower complication rates and excellent visual outcomes. Although MSICS is a cheaper option, better results concerning visual acuity are observed in Phacoemulsification surgery.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Complications between Manual Small Incision Cataract Surgery and Phacoemulsification

et al. 2021

View full text Add to dashboard Cite

Purpose: To compare per-operative and early post-operative complications between Manual Small Incision cataract surgery and Phacoemulsification in patients with Senile Cataract. Study Design: Quasi experimental study. Place and Duration of Study: Al-Ibrahim Eye Hospital Karachi from December 2018 to October 2019. Methods: Two hundred and seventy patients with senile Cataract were recruited for this study by convenient sampling technique. They were divided equally into two groups. Group I underwent Manual Small Incision Cataract Surgery (MSICS), whereas Group II underwent Phacoemulsification. Per-operative and early post-operative complications were recorded on day 1 in both groups. Data was analyzed using SPSS 24.0. Independent t-test was carried out with P-value of ≤0.05 was considered statistically significant. Results: Mean age group – I was 54.95 ± 11.0 and in Group – II was 57.09 ± 10.59 (p = 0.546). There were 72 (53.3%) males in group – I and 74 (54.8%) in group – II with a non-significant difference (p-value > 0.01). There was significant difference for posterior capsule rupture and striate keratitis between the two groups (p = 0.031 and 0.044 respectively). Rest of the study parameters was not statistically different in the both group. None of the groups had a nucleus drop and vitreous prolapse. No significant difference was seen between the two groups concerning iris trauma (p = 0.56), wound leakage (p = 0.15) and hyphema (p = 0.32). Conclusion: There is no significant difference between per-operative and early post-operative complications between MSICS and Phacoemulsification in patients with senile cataract except posterior capsular rupture and striate keratopathy which were more common in phacoemulsification group. Key Words: Cataract, Senile Cataract, Phacoemulsification, Small Incision Cataract Surgery.

show abstract

“…MSICS has also been shown to be less time consuming, less expensive, and less technology dependent than phacoemulsification, making it appropriate for advanced cataracts [7] . It has been recommended to use trypan blue dye staining of the anterior capsule [5,9] . Phacoemulsification machines are expensive to purchase and maintain, and they add relatively high costs of surgical consumables.…”

Section: Discussionmentioning

confidence: 99%

Surgically induced astigmatism in frown versus chevron incision in MSICS

Rathi¹,

Soni²,

Verma³

et al. 2020

Int. J. Med. Ophthalmol.

View full text Add to dashboard Cite

Cataract surgery remains the foremost cause of reversible blindness globally. Phacoemulsification requires expensive equipment, instruments and higher cost of disposables, along with a longer training curve. Manual small incision cataract surgery (MSICS) has evolved to provide excellent postoperative results, with minimal cost. In developing countries like India, patients present with white/advanced cataract, for which MSICS has proven to provide the best results. MSCIS can be used in any type of cataract, with any type of foldable/rigid intraocular lens implantation. Minimising surgically induced astigmatism is of paramount importance as the patient achieves good uncorrected vision postoperatively, which is the need of the hour. The Chevron incision in MSICS has been reported to provide the best results. We undertook the present study in 100 eyes with white cataract/nuclear sclerosis of grade 4-6 to analyse and compare MSCIS through the Frown incision and Chevron incision. The mean surgically induced astigmatism incision was more in the Frown group (0.82D±0.62) than in the Chevron group (0.55D±0.42), which was statistically significant. (p 0.017). In the Frown versus Chevron group, the best uncorrected visual acuity was 6/12 or better in 62% and 82% respectively. Thus, the Chevron incision was superior to the Frown incision for MSICS, while both yielded good postoperative results. MSICS is the most affordable and effective surgery of choice, especially for white/ hard cataracts.

show abstract

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

Abstract: Both techniques achieved good visual outcomes with low rates of complications. Manual SICS may be a viable alternative for cataract management in patients with FHI in settings with limited access to phacoemulsification.

Cited by 19 publications

References 18 publications

Cataract surgery in uveitis: a multicentre database study

Cataract surgery in uveitis: a multicentre database study

Comparison of Complications between Manual Small Incision Cataract Surgery and Phacoemulsification

Surgically induced astigmatism in frown versus chevron incision in MSICS

Contact Info

Product

Resources

About