Department of Cataract and Refractive Surgery, Karthik Netralaya Institution of Opthalmology, Bengaluru, Karnataka, India.
Department of Vitreo-Retina and Uvea, Karthik Netralaya Institution of Opthalmology, Bengaluru, Karnataka, India.
Indian J Ophthalmol. 2022 Nov;70(11):3923-3926. doi: 10.4103/ijo.IJO_1609_22.
Cataract development is a common sequelae associated with uveitis. Despite phacoemulsification being the popular method of cataract surgery today, manual small-incision cataract surgery (MSICS) may still be a safe and effective alternative because of several inherent benefits. There is not much literature and studies on the efficacy and safety of MSICS under topical anesthesia in complicated cataract in patients with uveitis. We aimed to study the safety and visual outcome of MSICS under topical anesthesia for post uveitis complicated cataract.
This was a retrospective observational study. The electronic medical records of adult patients who underwent MSICS under topical anesthesia for post uveitis cataract were reviewed. The records were reviewed and analyzed for preoperative clinical characteristics and visual acuity, intraoperative complications and postoperative visual acuity, and complications.
A total of 71 eyes of 59 patients were taken for final analysis. The average age of patients was 59.9 years. There was improvement in the best corrected visual acuity by 0.7 logMAR (P value <0.0001). Average follow-up period was 9.8 months. The mean gain in visual acuity in eyes that received preoperative steroids was 0.6 logMAR compared to the eyes that did not receive steroids (0.71 logMAR). The difference was not statistically significant (P = 0.407). Complications seen during long-term follow-up were recurrence (15.5%), cystoid macular edema (7%), Epiretinal membrane (8.5%), and posterior capsular opacification (5.5%).
With proper technique and precautions, MSICS can be safely and comfortably performed under topical anesthesia even in complicated cataracts with excellent visual and safety outcomes.
白内障的发生是葡萄膜炎的常见后遗症。尽管如今超声乳化术是白内障手术的主流方法,但由于其具有多种固有优势,手动小切口白内障手术(MSICS)仍不失为一种安全有效的替代方法。关于在葡萄膜炎患者复杂白内障情况下行表面麻醉下 MSICS 的疗效和安全性的文献和研究并不多。我们旨在研究表面麻醉下 MSICS 治疗葡萄膜炎后并发白内障的安全性和视力结果。
这是一项回顾性观察性研究。对接受表面麻醉下 MSICS 治疗葡萄膜炎后并发白内障的成年患者的电子病历进行了回顾和分析。对术前临床特征和视力、术中并发症和术后视力以及并发症进行了记录和分析。
最终纳入了 59 例 71 只眼进行分析。患者的平均年龄为 59.9 岁。最佳矫正视力提高了 0.7 对数视力(P 值 <0.0001)。平均随访时间为 9.8 个月。接受术前皮质类固醇治疗的眼视力提高的平均值为 0.6 对数视力,而未接受皮质类固醇治疗的眼为 0.71 对数视力(P = 0.407)。差异无统计学意义。长期随访期间出现的并发症有复发(15.5%)、黄斑囊样水肿(7%)、视网膜内膜(8.5%)和后发性白内障(5.5%)。
在适当的技术和预防措施下,即使在伴有复杂白内障的情况下,MSICS 也可在表面麻醉下安全舒适地进行,且具有良好的视力和安全性结果。