Rajkarnikar Sagar, Shrestha Dhan Bahadur, Dhakal Sachit, Shrestha Ram, Thapa Kamala, Gurung Anu
Shree Birendra Hospital, Chhauni, Nepalese Army Institute of Health Sciences (NAIHS).
Nepal J Ophthalmol. 2018 Jul;10(20):162-167. doi: 10.3126/nepjoph.v10i2.19185.
Cataract is a common ailment of the old age hindering daily activities leading to poor quality of life due to poor vision. It is the commonest cause of treatable blindness. In practice, extracapsular cataract excision and small incision cataract surgery are the two-common surgery for cataract these days in developing part like in Nepal. Between these two cataract surgeries, ECCE and SICS; SICS gives the better visual outcome.
This retrospective cohort study was carried out including 286 eyes which were operated either by conventional extracapsular cataract extraction or small-incision cataract surgery. The patient's demographics, preoperative vision, postoperative parameters/variables were studied from the patient's record keeping. The postoperative visual outcome and complications were compared in both groups at the immediate post-operative period and at 8 weeks follow up period.
Among the total 286 cases, 138 underwent ECCE and 148 underwent SICS. 145 (50.6%) were right eye, 141 (49.3%) were left eye. Among total operated cases, 123 (43%) were mature cataract, 97 (33.9%) immature cataract, 66 (23.1%) hyper-mature cataract. In 172 cases (60.1%) there was a good vision, in 104 cases (36.4%) it was borderline while in rest 10 (3.5%) cases it was poor on the 60th postoperative day. There was the better visual outcome (≥6/18) with SICS (78.3%) than ECCE (40.5%) (p<0.001) on the 60th post-operative day. Among cases undergoing SICS the complications were less than ECCE. (p<0.001, OR=5.72 (2.10-15.51)).
This study supports that SICS is safer than ECCE with less complication rate and better visual outcome in short term observation.
白内障是一种常见的老年疾病，由于视力不佳会妨碍日常活动，导致生活质量下降。它是可治疗性失明的最常见原因。在实践中，如今在尼泊尔等发展中地区，囊外白内障摘除术和小切口白内障手术是两种常见的白内障手术方式。在这两种白内障手术（即囊外白内障摘除术和小切口白内障手术）中，小切口白内障手术能带来更好的视觉效果。
开展了这项回顾性队列研究，纳入了286只接受了传统囊外白内障摘除术或小切口白内障手术的眼睛。从患者的病历记录中研究患者的人口统计学资料、术前视力、术后参数/变量。在术后即刻和术后8周随访期比较两组的术后视觉效果和并发症情况。
在总共286例病例中，138例接受了囊外白内障摘除术，148例接受了小切口白内障手术。145只（50.6%）为右眼，141只（49.3%）为左眼。在所有手术病例中，123例（43%）为成熟白内障，97例（33.9%）为未成熟白内障，66例（23.1%）为过熟白内障。在术后第60天，172例（60.1%）视力良好，104例（36.4%）临界，其余10例（3.5%）视力较差。术后第60天，小切口白内障手术组的视觉效果更好（≥6/18）的比例为78.3%，高于囊外白内障摘除术组的40.5%（p<0.001）。接受小切口白内障手术的病例并发症少于囊外白内障摘除术组。（p<0.001，OR=5.72（2.10 - 15.51））。
本研究支持在短期观察中，小切口白内障手术比囊外白内障摘除术更安全，并发症发生率更低，视觉效果更好。
