Sutureless Cataract Surgery With Nucleus Extraction: Outcome of a Prospective Study in Nepal

Hennig, Albrecht; Kumar, Jitendra; Yorston, David; Foster, Allen

doi:10.1097/00132578-200307000-00012

Cited by 30 publications

(41 citation statements)

References 7 publications

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“…Phacoemulsification machine is not required in MSICS in which nucleus is removed through a 6.5‐mm sclerocorneal tunnel. Several centres have reported success with MSICS (Hennig et al. 2003; Venkatesh et al.…”

Section: Introductionmentioning

confidence: 99%

Prospective randomized comparative study of macular thickness following phacoemulsification and manual small incision cataract surgery

Ghosh¹,

Roy²,

Biswas³

et al. 2010

Acta Ophthalmologica

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. Purpose: To compare macular thickness following uncomplicated phacoemulsification with foldable acrylic lens and manual small incision cataract surgery (MSICS) with non‐foldable polymethyl methacrylate (PMMA) lens implantation. Methods: Prospective study was carried out with one eye each of 224 patients with senile cataract randomized into two groups, phacoemulsification and MSICS, by simple 1:1 randomization. Following surgery by either of the two methods, macular thickness was measured by optical coherence tomography (OCT) on the 1st, 7th, 42nd and 180th postoperative day. Main outcome measure was postoperative macular thickness. Results: On the first postoperative day, central subfield mean thickness (CSMT) in MSICS group was 192.8 ± 17.9 μm and that in phacoemulsification group was 192.1 ± 27.4 μm, with no significant difference (p = 0.12). On the 7th day, CSMT in MSICS group (198.9 ± 21.4 μm) was significantly (p = 0.04) more than that in phacoemulsification group (193.1 ± 19.3 μm). On the 42nd day, CSMT in MSICS group was 207.8 ± 26.3 μm and that in phacoemulsification group was 198.3 ± 23 μm, the difference being significant (p = 0.007). Clinically macular oedema was not diagnosed in any of the patients at any visit. The increase in macular thickness was sub‐clinical and did not affect final visual outcome in any patient. Conclusion: In spite of the greater theoretical risk of increased postoperative inflammation following MSICS, there was no evidence of cystoid macular oedema, either clinically or on OCT. However, chance of sub‐clinical increase in CSMT was more following MSICS compared to phacoemulsification.

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Section: Introductionmentioning

confidence: 99%

Prospective randomized comparative study of macular thickness following phacoemulsification and manual small incision cataract surgery

Ghosh¹,

Roy²,

Biswas³

et al. 2010

Acta Ophthalmologica

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“…7 Some recent studies of high volume cataract surgery in India and Nepal report good results. [8][9][10][11][12][13][14] In order to investigate whether high volume surgeries can be performed routinely, without compromising quality, we retrospectively reviewed the results of 593 surgeries performed by three experienced surgeons, achieving surgical times of 3.75 minutes/case (16-18 cases/hour), utilising the technique of manual small incision cataract surgery (manual SICS).…”

mentioning

confidence: 99%

Outcomes of high volume cataract surgeries in a developing country

Venkatesh

Radhakrishnan²,

Balent³

et al. 2005

British Journal of Ophthalmology

149

116

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Aim: To analyse the outcome of high volume cataract surgery in a developing country, community based, high volume eye hospital. Methods: In a non-comparative interventional case series, the authors reviewed the surgical outcomes of 593 patients with cataract operated upon by three high volume surgeons on six randomly selected days. There were 318 female (54%) and 275 male (46%) patients. Their mean age was 59.57 (SD 10.13) years. The majority of the patients underwent manual small incision cataract surgery (manual SICS). Extracapsular cataract extraction with posterior chamber intraocular lens (ECCE-PCIOL) and intracapsular cataract extraction (ICCE) were also done on a few patients as clinically indicated. Results: Best corrected visual acuity of >6/18 was achieved in 94% of the 520 patients who could be followed up on the 40th postoperative day (88% follow up rate). Intraoperative and immediate postoperative complications as defined by OCTET occurred in 11 (1.9%) and 75 (12.6%) patients, respectively. Average surgical time of 3.75 minutes per case (16-18 cases per hour) was achieved. Statistically significant risk factors for outcomes were found to be age .60, sex, and surgeon. Conclusion: High volume surgery using appropriate techniques and standardised protocols does not compromise quality of outcomes.O f the total estimated 38 million blind people in the world, 9-12 million are in India.1 2 Estimates report that 50%-80% of these people are blind because of cataract.1 2 In addition to the backlog, an additional 3.8 million become blind each year because of cataract.3 In 2000, 3.5 million cataract operations were performed, 4 but this remains insufficient to treat the backlog and the newly blind. In 1994, Natchiar et al suggested that productivity per individual surgeon/unit should be increased through a high volume, high quality cataract surgery approach to solve the problem of India's curable blind.5 More recently, the World Health Organization global initiatives have called for a dramatic increase in surgical volumes worldwide. 6 However, it is becoming more evident that outcomes of cataract surgery are not always good and this aspect of surgical services must be further examined.7 Some recent studies of high volume cataract surgery in India and Nepal report good results. [8][9][10][11][12][13][14] In order to investigate whether high volume surgeries can be performed routinely, without compromising quality, we retrospectively reviewed the results of 593 surgeries performed by three experienced surgeons, achieving surgical times of 3.75 minutes/case (16-18 cases/hour), utilising the technique of manual small incision cataract surgery (manual SICS). PATIENTS AND METHODSSurgeons consistently performing more than 80 surgeries per day in six operating hours at Aravind were defined as ''high volume surgeons.'' There were six such high volume surgeons during the period of analysis from April 2002-March 2003. From these six surgeons, three were randomly chosen using a lot method. There were 28 days (clusters) dur...

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“…[1][2][3] Hennig et al, 4 found that visual acuity improved to 6/18 or better in 96.2% of eyes after 6 weeks and 95% after 1 year after small incision cataract surgery (SICS) and posterior chamber intraocular lens implantation (PC-IOL) implantation.…”

Section: Introductionmentioning

confidence: 99%