Visual Outcomes And Complications Of Manual Small Incision Cataract Surgery At Residents Learning Curve In A Reference Hospital In Mexico
Published 2023 - 41st Congress of the ESCRS
Reference: PO0452 | DOI: 10.82333/p8qw-4y04
Authors: Hugo Alonso Reyes Reyes* 1 , José Alberto Rocha Medina 2 , Marcos Ivo Ferreira Ríos 2
1Segmento Anterior,Instituto de Oftalmología Fundación Conde de Valenciana,Ciudad de México,Mexico;Córnea y Cirugía Refractiva,Instituto de Microcirugía Ocular,Barcelona,Spain, 2Segmento Anterior,Instituto de Oftalmología Fundación Conde de Valenciana,Ciudad de México,Mexico
To examine postoperative visual outcomes, as well as intraoperative and early postoperative complications in patients undergoing Manual Small Incision Cataract Surgery (MSICS) in an academic setting at a reference hospital in Mexico
Phacoemulsification technique with intraocular lens implantation is the most widely used, and therefore residency training programs have focused on emphasizing the learning of this technique much more than others such as extracapsular extractions, since more than 80% of newly graduated physicians perform two or fewer cases of extracapsular cataract extraction during their residency in ophthalmology.
Is a descriptive and longitudinal study about one year follow up patients with senile cataract diagnosis , scheduled for a primary MSICS technique where phacoemulsification was expected to be difficult. All cases of MSICS were performed by a resident as main surgeon and supervised by a attending ophthalmologist.
El análisis incluyó a 18 pacientes, la MAVC preoperatoria media fue de 2,30 ± 0,682 logMAR (SD, 95% IC) (movimiento de la mano) mejorando a una MAVC de 0,36 ± 121 logMAR (20/40 snellen). El astigmatismo queratométrico preoperatorio fue de -1,55 ± 1,28 D, mientras que el astigmatismo posoperatorio fue de -1,63 ± 1,14 D, siendo la diferencia entre estos el SIA de 0,089 ± 1,02. La complicación intraoperatoria más frecuente fue la PCR, que se presentó en 5 casos (27%), un caso (5,6%) de ruptura del colgajo escleral y un caso con diálisis zonular. Las complicaciones postoperatorias incluyeron 3 casos con hongos vítreos (16%), dos casos de desprendimiento coroideo (11%) y un caso de material del cristalino retenido en la cámara anterior (5,6%).
The present study suggests that MSICS performed by residents with appropriate supervision is a safe and effective method of cataract extraction, particularly for mature cataracts. The study showed visual results and complication rates that were similar to phacoemulsification performed by residents in the international literature.
This resident case series of MSICS suggests that properly supervised novice surgeons can safely and effectively perform MSICS, especially in challenging cases. Residents and instructors should pay special attention to wound construction during MSICS, as this will help to construct self-sealing incisions and avoid complications.