Posters

Is manual small-incision cataract surgery (MSICS) a better option than phacoemulsification for managing pseudoexfoliation cataracts in a developing nation?

Poster Details

First Author: N.Dash INDIA

Co Author(s):    D. Choudhury                    

Abstract Details

Purpose:

To compare the results of MSICS and phacoemulsification procedures carried out on cataracts with pseudoexfoliation syndrome (PXS).

Setting:

Prospective, interventional, single-centre study of 1 year duration (January 2018 - December 2018) at a tertiary care hospital in Odisha, India.

Methods:

30 eyes of 30 patients with diagnosed PXS, and meeting the requirements of inclusion criteria, were taken into account. They were divided into two groups : Group-A and Group-B. Group-A consisted of eyes undergoing MSICS with posterior chamber intraocular lens(PCIOL) implantation and Group-B included eyes undergoing phacoemulsification (stop-and-chop technique) with PCIOL implantation. 21 eyes were included in Group-A and 9 eyes in Group-B. All operations were carried out by a single surgeon. Intra-operative complications and conversion(if any) to MSICS were noted. Post-operative best corrected visual acuity(BCVA) was noted on day-1, day-7, 1 month and 3 months.

Results:

Problems were encountered due to poor pupillary dilatation and zonular dehiscence. Sphincterotomy was done in 26.1% cases. The BCVA noted at 3 months was as follows : 20/20-20/40 in 9 eyes (30%)[Group-A - 4 eyes,Group-B - 5 eyes) , 20/60-20/120 in 19 eyes(63.3%)[Group-A - 16 eyes,Group-B - 3 eyes] and 20/200 or less in 2 eyes (6.7%)[Group-A - 1 eye,Group-B - 1 eye]. Conversion from phacoemulsification to MSICS was done in 1 eye. Corneal edema was greater in eyes with MSICS but was statistically insignificant.

Conclusions:

Since presence of PXS complicates surgical procedures, outcome tend to depend more on the degree of disease than on the procedure undertaken. MSICS in the hands of an experienced surgeon can produce favorable outcome, and can be considered  as an equally viable option in the absence of infrastructure facilitating phacoemulsification in PXS cases.

Financial Disclosure:

None