Zawar Swati V, Gogate Parikshit
Tulsi Eye Hospital, Nashik, India.
Eur J Ophthalmol. 2011 Nov-Dec;21(6):748-53. doi: 10.5301/EJO.2011.6521.
To assess safety and efficacy of temporal manual small incision cataract surgery (SICS) in context to visual outcome, astigmatism, and complications.
This involved sclerocorneal tunnel, capsulotomy, and hydrodissection. The incision was made with number 11 disposable surgical blade (costing Indian Rs. 2.50, $0.05). Nucleus extraction was done by phaco-sandwich method with the help of vectis and dialer. Posterior chamber intraocular lens implantation was done according to biometric findings. A record of intraoperative and postoperative complications was made. The final postoperative assessment of astigmatism was done with spectacle correction on the 45th day as per the refraction findings.
Two thousand eyes were operated by temporal, manual small incision sutureless technique. Uncorrected visual acuity was >6/18 in 1636 (81.7%) patients on the first postoperative day, in 1652 (82.6%) patients at 2 weeks, and in 1732 (88.6%) patients at 6 weeks. Best-corrected visual acuity (BCVA) >6/18 was achieved in 1868 (93.4%) patients at 6 weeks, with 46 (2.3%) having BCVA <6/60, 24 (1.2%) of whom had preexisting retinal pathology. At 6 weeks, 1876 (93.8%) eyes had with-the-rule and 134 (6.2%) against-the-rule astigmatism (mean 0.7±1.25 D). Iris prolapse was noted in 3 (0.15%), wound leak in 3 (0.15%), and transient corneal edema in 136 (6.8%) eyes. Average surgery time was 6 minutes.
Temporal SICS with number 11 disposable surgical blade and nucleus delivery by phaco-sandwich method gave excellent outcome with minimal astigmatism and low complication rate at economic cost.
从视力结果、散光和并发症方面评估颞侧手动小切口白内障手术（SICS）的安全性和有效性。
该手术包括巩膜隧道切口、晶状体囊切开术和水分离术。使用11号一次性手术刀片（印度售价2.50卢比，0.05美元）制作切口。借助晶状体镊和拨核器通过超声乳化三明治法取出晶状体核。根据生物测量结果植入后房型人工晶状体。记录术中及术后并发症。术后第45天根据验光结果通过眼镜矫正对散光进行最终评估。
采用颞侧手动小切口无缝合技术对2000只眼进行了手术。术后第1天，1636例（81.7%）患者的未矫正视力>6/18，术后2周时1652例（82.6%）患者达到该视力，术后6周时1732例（88.6%）患者达到该视力。术后6周时，1868例（93.4%）患者的最佳矫正视力（BCVA）>6/18，46例（2.3%）患者的BCVA<6/60，其中24例（1.2%）患者术前存在视网膜病变。术后6周时，1876只眼（93.8%）有顺规散光，134只眼（6.2%）有逆规散光（平均0.7±1.25 D）。3只眼（0.15%）出现虹膜脱垂，3只眼（0.15%）出现伤口渗漏，136只眼（6.8%）出现短暂性角膜水肿。平均手术时间为6分钟。
使用11号一次性手术刀片进行颞侧SICS并通过超声乳化三明治法娩出晶状体核，可取得极佳的效果，散光最小且并发症发生率低，成本经济。
