CATARACT SURGERIES BY PHACO-SANDWICH TECHNIQUE THROUGH SCLEROCORNEAL TUNNEL, A COHORT STUDY IN OMAN
Abstract
Background: To evaluate the changes in Preoperative and Postoperative keratometry results andrapid visual rehabilitation in Cataract surgery by our phaco-sandwich technique through the selfsealing sclero-corneal tunnel incision without phacoemulsification. Methods: 96 eyes of 88patients with age-related cataracts underwent small incision suture less cataract surgery withoutphacoemulsification. All eyes were operated by the phaco-sandwich technique throughsclerocorneal tunnel with 6 mm frown-shaped external scleral incision. 6 mm single piece PMMAlens was implanted in the capsular bag. Patients were evaluated at 1week, 4 weeks and 12 weekspost-operatively. Results: Ninety six eyes of eighty eight patients were our cohort. During the firstpost-operative week 8 eyes (8.3%) had uncorrected visual acuity (UCVA) of 6/6. By the end of 12post-operative weeks, 33 eyes(34.5%) had UCVA of 6/6. 64 (66.7%), 72(75%) and 80(83.3%)eyes had best correctable visual acuity (BCVA) of 6/6 after 4 weeks, 8 weeks and 12 weeksrespectively. 64 (66.7%) eyes after 4 weeks, 72 (75%) after 8 weeks and 80 (83%) after 12 weekshad best correctable visual acuity (BCVA) of 6/6. Conclusion: Suture less, small-incision cataractsurgery is an economical, safe and effective method of managing cataract cases. This techniquealso ensures satisfactory and rapid rehabilitation for patients. This procedure can be effectivelyapplied to clear the backlog of cataract-related blindness in places wherein the resources for phacofacilities are not available.Keywords : Small incision cataract surgery, Phacoemulsification, PhacosandwichReferences
Standford-Smith J. Sutureless Cataract Surgery: Principles
and Steps. Community Eye Health 2003, 16(48):51-53.
Natchiar G, Robin AL, Thulasiraj R. Attacking the backlog
of India’s curable blind; the Aravind Eye Hospital model.
Arch Ophthalmol. 1994; 112:987-993.
Fry LL. The Phaco sandwich technique. In: Rozakis
GW(Ed),Cataract Surgery: Alternative Small incision
techniques. Thorofare NJ Slack1990; 91-110.
Gutierrez-Carmona FJ. Mannual multiphacofragmentation
through a 3.2 mm clear corneal incision. J Cataract Refract
Surg 2000; 26:1523-1528,.
Zvia Burgansky MD, ItzhakIsakov MD, Haggay Avizmer
MD, Elisha Bartov MD. Minimal astigmatism after
sutureless planned extracapsular cataract extraction.
J Cataract Refract Surg 2002; 28:499-503.
Singer JA. Frown incision for minimizing induced
astigmatism after small incision cataract surgery with rigid
optic intraocular lens implantation. J Cataract Refract Surg
;17: 677-688 .
Hayashi K, Hayashi H, Nakao F, Hayashi F. Risk factors for
corneal endothelial injury during phacoemulsification.
J Cataract Refract Surg 1996;22:1079-84.
Fish JR. Creation of a no-stitch cataract incision. J Cataract
Refract Surg 1991;17:713-15
Atisub T, Thongplengsri C, Panegputhiopong P. Small
Incision Sutureless Cataract Surgery with and without
Phakoemulsification, Thai J Ophthalmol 1992; 6(1):31-39.
Anders N, Pham DT, Antoni HJ, Wollensk J. Postoperative
astigmatism and relative strength of tunnel incision: a
prospective clinical trial. J Cataract Refractive Surg 1997;23:
-36.
Guzek JP, Ching A. Small-incision manual extracapsular
cataract surgery in Ghana, West Africa. J cataract Refract
Surg. 2003 Jan;29(1):57-64.
Sinskey RM, Stoppel JO. Induced astigmatism in a 6.0 mm
no-stitch frown incision. J Cataract Refract Surg 1994;
: 406-409
Sood A, Kumar S, Badhu B, Kulshreshtha V. Astigmatism
and Corneal Thickness in Conventional Large Incision
Versus Manual Small Incision Cataract Surgery. Asian J
Ophthalmology 2002; 4(4):2-6.
Thomas R, Kuriakose T, George R . Towards Achieving
small-incision Cataract Surgery 99.8% of the time. Indian J
Ophthalmol 2000;48(2):145-51
Albrecht Hennig. Suturless Non-phaco Cataract Surgery: A
solution to reduce worldwide cataract blindness. Community
Eye Health 2003; 16(48):49-51.
