A comparative study of sclero-corneal and clear corneal tunnel incision in manual small-incision cataract surgery. 2011

S Archana, and A K Khurana, and U Chawla
Regional Institute of Ophthalmology, Pt. B. D. S. PGIMS, Rohtak, India.

BACKGROUND Cataract surgery techniques have improved a lot over the years from couching to the latest micro-incision cataract surgery. OBJECTIVE To compare the temporal sclero-corneal and clear corneal tunnel incisions in patients undergoing manual small-incision cataract surgery (SICS) with respect to the surgically-induced astigmatism. METHODS The present study included 60 patients who underwent manual SICS with posterior chamber intraocular lens implantation. Group A comprised of 30 patients, selected randomly, who underwent sutureless manual SICS through 6 mm curvilinear clear corneal tunnel incision made temporally and Group B comprised of 30 patients, selected randomly, who underwent sutureless manual SICS through 6 mm straight sclero-corneal tunnel made temporally. The patients were assessed at 1 week, 2 weeks, 1 month and 2 months post-operatively and visual acuity and keratometry findings were recorded. The amount of surgically induced astigmatism was calculated using Holladay's formula. METHODS Numerical data were compared between the two groups using unpaired Student's t-test. The p value of less than 0.50 was considered significant. RESULTS The mean induced astigmatism in Group A was 2.69 ± 0.84 D at 1 week, 2.31 ± 0.77 D at 2 weeks; 2.03 ± 0.82 D at 4 weeks and 1.98 ± 0.54 D at 8 weeks post-operatively. In group B, it was 1.85 ± 0.62 D, 1.56 ± 0.54 D, 1.35 ± 0.49 D and 1.34 ±0.45 D at 1 week, 2 weeks, 4 weeks and 8 weeks postoperatively. Uncorrected visual acuity (UCVA) of 20/ 20 was seen in 20 % of patients in group A and in 40 % in group B at 8 weeks postoperatively. CONCLUSIONS Surgically-induced astigmatism is significantly higher in clear corneal manual SICS than in sclero-corneal. Our study confirmed the safety and improvement in visual acuity after small-incision cataract surgery using sclero-corneal tunnel incision.

UI MeSH Term Description Entries
D008297 Male Males
D008866 Microsurgery The performance of surgical procedures with the aid of a microscope.
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012029 Refraction, Ocular Refraction of LIGHT effected by the media of the EYE. Ocular Refraction,Ocular Refractions,Refractions, Ocular
D002387 Cataract Extraction The removal of a cataractous CRYSTALLINE LENS from the eye. Enzymatic Zonulolysis,Phakectomy,Cataract Extractions,Enzymatic Zonulolyses,Extraction, Cataract,Extractions, Cataract,Phakectomies,Zonulolyses, Enzymatic,Zonulolysis, Enzymatic
D003315 Cornea The transparent anterior portion of the fibrous coat of the eye consisting of five layers: stratified squamous CORNEAL EPITHELIUM; BOWMAN MEMBRANE; CORNEAL STROMA; DESCEMET MEMBRANE; and mesenchymal CORNEAL ENDOTHELIUM. It serves as the first refracting medium of the eye. It is structurally continuous with the SCLERA, avascular, receiving its nourishment by permeation through spaces between the lamellae, and is innervated by the ophthalmic division of the TRIGEMINAL NERVE via the ciliary nerves and those of the surrounding conjunctiva which together form plexuses. (Cline et al., Dictionary of Visual Science, 4th ed) Corneas
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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