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Innovative way of managing hard cataracts
Session Title: Surgical Outcomes
Session Date/Time: Monday 07/10/2013 | 08:00-09:30
Paper Time: 08:06
Venue: Auditorium (First Floor)
First Author: : D.Nath INDIA
Co Author(s): : K. SAMBHAV K. KRISHNA S. SINGH A. SINGH
To manage hard cataract, depending upon the size of the nucleus
Rural eye care setting in northern central India.
All patients underwent detailed pre-operative evaluation. All surgeries were performed by single surgeon under topical or peribulbar anesthesia. Side ports were made at 2 or 10o clock depending upon the eye being operated. Anterior capsule was stained with trapan blue and large continuous curvilinear capsulorrhexis was performed. Liquefied cortex was washed off. Size of the nucleus is assessed. If the nucleus was 3 5 mm in size additional entry was made with keratome and phacoemulsification was performed. If the nucleus size was 5 6 mm, the nucleus was chopped into 2 pieces with help of Nath cannula and chopper and then phacoemulsification is performed. If the nucleus size was greater than 6 mm, small incision cataract surgery was performed with help our innovative way of manual dissection and delivery. All patients had implantation of posterior chamber intra ocular lens (PCIOL). Incision wounds were hydrated and checked for any leaks at the end of surgery.
Retrospective analysis of prospectively collected data of 518 eyes of 418 patients over 2 years. The data of all patients was retrieved from 1st Jan 2009 to 31st Dec 2012 and was analyzed. Complete pre-operative details and post-operative data were compared. Respective statistical tests where ever indicated. In our cohort of 518 patients, 225 patients had nucleus size greater than 6 mm, 183 patients had nucleus size between 5 6 mm and the rest 110 had size between 3 5 mm. All patients had vision of perception of light positive and projection of rays accurate at presentation. Best corrected visual acuity at the final follow up ranged from 20/20 to 20/40. One patient developed posterior capsular rent during surgery and in the very same patient PCIOL was placed in sulcus. None of the patient developed endophthalmitis. In none of the cases sutures were needed at the end of surgery.
Hard cataracts are still common in underdeveloped and developing nation. Our way of managing these kind of cases based upon the size of nucleus is simple and have good visual outcome.