Authors :
Dr.Sujit Kumar Biswas; Dr. Quamrul Islam; Dr. Rajib Husain; Dr. Suborna Sultana; Dr. Nahid Anjum
Volume/Issue :
Volume 7 - 2022, Issue 4 - April
Google Scholar :
https://bit.ly/3IIfn9N
Scribd :
https://bit.ly/3kWXudV
DOI :
https://doi.org/10.5281/zenodo.6535997
Abstract :
To evaluate the astigmatic change after Manual
Small Incision Cataract Surgery with chevron type of
incision.
Design: A prospective interventional study.
Materials & Methods: A total 100 cases were selected
who underwent manual small incision cataract surgery
with chevron incision for that one year period
irrespective of gender. This study was done in cataract
clinic at Chittagong Eye Infirmary and Training
Complex. Related all pre- and postoperative data were
recorded according to the protocol of the hospital. All
surgeries were done under peribulbar anesthesia. A “V”
shaped chevron partial thickness sclera incision was
done on the superior quadrant of every patient by a
keratome. Pocket tunnel is dissected with a crescent
knife. All other steps of were done like standard small
incision cataract surgery. All intraocular lenses (IOLs)
were implanted in capsular bag. Post operatively
patients were treated with topical corticosteroid six times
daily approximately four weeks then tapered, topical
antibiotic four times daily for one week and topical
cycloplegic once daily for two weeks. All patients were
followed up on 1st
postoperative day, 7th postoperative
day and after one month.
Results: Mean ages of these patients were 59.66 ± 10.81
years (ranged 30-70 years). Here we found that Chevron
Incision is relatively more stable in ATR astigmatism
group than WTR astigmatism (63.04% and 72.71%
respectively). But in NO astigmatism group it gives
opposite results, that that was changed to WTR
astigmatism more than ATR astigmatism (60% and 40%
respectively). A significant change occurred between
pre- and post-operative astigmatism in different groups
(p-0.001). Sixty nine percent (69%) gain Complete
success i.e, incision induced astigmatism was up to 0.50
D, 27% were in Qualified success and only 4% were
failed. Post operative final visual outcome of this study
group is excellent, 98% achieved BCVS equal or better
than 6/18. No patient showed significant post operative
complication. Tunnel construction was the most difficult
step in this type of incision through the sclera.
Conclusion: This prospective study showed chevron
incision causes a significant change in astigmatism
postoperatively. Although magnitude of surgically
induced astigmatism was significant, outcome of chevron
incision in term of final postoperative vision is excellent.
Tunnel construction was somewhat difficult. We have to
compare with other type of incision to assess the efficacy
of Chevron incision.
Keywords :
Chevron incision, manual small incision cataract surgery (MSICS), with the rule astigmatism (WTR), against the rue astigmatism (ATR).
To evaluate the astigmatic change after Manual
Small Incision Cataract Surgery with chevron type of
incision.
Design: A prospective interventional study.
Materials & Methods: A total 100 cases were selected
who underwent manual small incision cataract surgery
with chevron incision for that one year period
irrespective of gender. This study was done in cataract
clinic at Chittagong Eye Infirmary and Training
Complex. Related all pre- and postoperative data were
recorded according to the protocol of the hospital. All
surgeries were done under peribulbar anesthesia. A “V”
shaped chevron partial thickness sclera incision was
done on the superior quadrant of every patient by a
keratome. Pocket tunnel is dissected with a crescent
knife. All other steps of were done like standard small
incision cataract surgery. All intraocular lenses (IOLs)
were implanted in capsular bag. Post operatively
patients were treated with topical corticosteroid six times
daily approximately four weeks then tapered, topical
antibiotic four times daily for one week and topical
cycloplegic once daily for two weeks. All patients were
followed up on 1st
postoperative day, 7th postoperative
day and after one month.
Results: Mean ages of these patients were 59.66 ± 10.81
years (ranged 30-70 years). Here we found that Chevron
Incision is relatively more stable in ATR astigmatism
group than WTR astigmatism (63.04% and 72.71%
respectively). But in NO astigmatism group it gives
opposite results, that that was changed to WTR
astigmatism more than ATR astigmatism (60% and 40%
respectively). A significant change occurred between
pre- and post-operative astigmatism in different groups
(p-0.001). Sixty nine percent (69%) gain Complete
success i.e, incision induced astigmatism was up to 0.50
D, 27% were in Qualified success and only 4% were
failed. Post operative final visual outcome of this study
group is excellent, 98% achieved BCVS equal or better
than 6/18. No patient showed significant post operative
complication. Tunnel construction was the most difficult
step in this type of incision through the sclera.
Conclusion: This prospective study showed chevron
incision causes a significant change in astigmatism
postoperatively. Although magnitude of surgically
induced astigmatism was significant, outcome of chevron
incision in term of final postoperative vision is excellent.
Tunnel construction was somewhat difficult. We have to
compare with other type of incision to assess the efficacy
of Chevron incision.
Keywords :
Chevron incision, manual small incision cataract surgery (MSICS), with the rule astigmatism (WTR), against the rue astigmatism (ATR).
