A Prospective Randomized Clinical Trial of Phacoemulsification vs Manual Sutureless Small-Incision Extracapsular Cataract Surgery in Nepal

Ruit, Sanduk; Tabin, Geoffrey; Chang, David F.; Bajracharya, Leena; Kline, Daniel C.; Richheimer, William; Shrestha, Mohan Krishna; Paudyal, Govinda

doi:10.1016/j.ajo.2006.07.023

Cited by 258 publications

(281 citation statements)

References 13 publications

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“…The visual results are similar to randomised control trails comparing phacoemulsification and MSICS performed in India and Nepal. 10,11 BBC cataracts may require a larger scleral tunnel (6.5-7.5 mm) for extraction of nucleus from the eye, which can induce postoperative corneal astigmatism. A temporal incision may help control corneal astigmatism.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of manual small incision cataract surgery for brunescent and black cataracts

Venkatesh

Tan

Singh

et al. 2008

Eye

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Aims To evaluate the safety, visual outcome and complications of manual small incision cataract surgery (MSICS) in the treatment of patients with brunescent and black cataract (BBC). Methods In a non-randomised interventional case series, 102 consecutive patients with BBC underwent cataract extraction by MSICS, with staining of the anterior capsule by trypan blue. Results Of the 102 eyes with BBC, MSICS was performed through superior scleral tunnel (SST) in 31 eyes (30.4%) and through temporal scleral tunnel (TST) in 71 eyes (69.6%). The main intraoperative complication was posterior capsule rupture in two patients (2.0%). Postoperatively, 20 eyes (19.6%) developed corneal oedema. Mild iritis was seen in six eyes (5.9%) and moderate iritis with fibrin membrane formation occurred in three eyes (2.9%). On the 40th postoperative day, 80 patients (78.4%) achieved uncorrected visual acuity of 6/18 or better, and 99 (97.1%) had best-corrected visual acuity of 6/18 or better. Patients in the SST group had significantly higher postoperative astigmatism compared to those in the TST group (À1.08 D vs À0.72 D, P ¼ 0.017). Conclusion MSICS with trypan blue staining of the anterior capsule is a safe and effective method of cataract extraction for patients with BBC.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of manual small incision cataract surgery for brunescent and black cataracts

Venkatesh

Tan

Singh

et al. 2008

Eye

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“…In this respect, they conducted a single-center prospective and descriptive study of 100 eyes. Other authors have conducted similar studies in developing countries [2,3,[5][6][7][8].…”

Section: Discussionmentioning

confidence: 95%

“…This technique allows to work in a self-sealing anterior chamber. The postoperative astigmatism is a complication of cataract surgery [5][6][7][8]. The authors wanted to assess astigmatism in this recent technique.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of astigmatism in manual and sutureless small incision cataract surgery

Kd¹,

Billong²,

Vonor³

et al. 2016

New Front Ophthalmol

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Introduction: Cataract surgery is experiencing progress and adaptations in recent years with the aim to obtain better anatomical and functional results. Extraction of cataract by phacoemulsification has become a gold standard with its multiple variants. In developing countries, the cataract surgery by manual and sutureless small incision technique (MSICS) is increasingly practiced. The aim of this study is to assess astigmatism before and after cataract surgery by MSICS.

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“…6 In low-and middle-income countries (LMICs), trials of phacoemulsification vs small incision manual extracapsular cataract surgery (SICS) have had variable results, with two trials showing the superiority of phaco 7,8 and two showing little difference between the two methods. 9,10 However, a recent meta-analysis showed that phacoemulsification was more likely than SICS to give an uncorrected visual acuity of 6/18 or better soon after surgery. 11 The equipment required for phacoemulsification is expensive and this technique has not been widely adopted in lower-income settings.…”

Section: Introductionmentioning

confidence: 99%

Foldable vs rigid lenses after phacoemulsification for cataract surgery: a randomised controlled trial

Hennig¹,

Puri²,

Sharma³

et al. 2014

Eye

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Purpose To compare the outcomes of phacoemulsification with either a 2.5-mm clear corneal incision and a foldable intraocular lens (IOL) or a 5-mm sclerocorneal tunnel incision and a rigid polymethyl methacrylate (PMMA) IOL. Methods In a prospective, randomised clinical trial of phacoemulsification cataract surgery, 1200 patients received either a foldable hydrophilic acrylic IOL through a 2.5-mm corneal incision or an inexpensive rigid PMMA IOL via a 5-mm sclerocorneal tunnel. Intra-and post-operative data and visual acuity at discharge, 6 weeks, and 1 year follow-up were analysed.Results At 1 year after surgery, 996 (83.0%) patients were followed up with an uncorrected visual acuity of 6/18 or better in 90.3% of the foldable and 94.3% in the rigid IOL group (risk ratio (RR) 0.96, 95% confidence intervals (CI) 0.92-0.99). Poor outcome (best-corrected acuity 6/60 or worse) occurred in 1.0% and 0.4%, respectively (RR 4.28,). The surgical cost of consumables and overall surgical time were similar in both groups; however, the cost of the foldable IOL was eight times higher than the PMMA IOL. Posterior capsule opacification was more common in the rigid IOL group at 12 months (36.1% vs 23.3%); however, this did not affect postoperative vision. Conclusion In the hands of experienced cataract surgeons, phacoemulsification with implantation of a foldable or a rigid IOL gives excellent results. Using an inexpensive rigid PMMA IOL will make phacoemulsification more affordable for poor patients in low-and middle-income countries.

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A Prospective Randomized Clinical Trial of Phacoemulsification vs Manual Sutureless Small-Incision Extracapsular Cataract Surgery in Nepal

Cited by 258 publications

References 13 publications

Safety and efficacy of manual small incision cataract surgery for brunescent and black cataracts

Safety and efficacy of manual small incision cataract surgery for brunescent and black cataracts

Assessment of astigmatism in manual and sutureless small incision cataract surgery

Foldable vs rigid lenses after phacoemulsification for cataract surgery: a randomised controlled trial

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