MANUAL NUCLEAR DIVISION IN ANTERIOR CHAMBER WITH MVR BLADE FOR 4MM SICS – SAFETY AND EFFICACY
Abstract
Purpose: Critical evaluation with respect to intraoperative and postoperative complications, visual outcome and cost effectiveness in a 4mm small incision cataract surgery by phacofracture with MVR blade and conventional SICS.
Methods: 300 patients were divided into two groups 150 each. Patients had grade I-IV nuclear sclerosis and were operated under peribulbar anesthesia. 4 mm scleral tunnel made 2mm behind limbus. Capsulorhexis done, Hydrodissection done. Nucleus prolapsed in anterior chamber. Viscoelastic injected behind and in front of nucleus. Wire vectis passed through the main incision below the nucleus to stabilize it 20G MVR blade was introduced from 11O’clock and pierced through nucleus substance.MVR blade pressed against wire vectis and nucleus was bisected into two halves. The fragmented nucleus halves removed through main incision. Cortical wash was given and foldable IOL was implanted.
Results: Out of 300 patients 1.03% had grade I cataract, 20.05% had Grade II, 55.01% had Grade III and 24.04% had Grade IV. Commonest intraoperative complication was iridodialysis and extended rhesix, while post operatively striate keratopathy and cystoids macular edema were noted. There was no significant difference noted between the two groups. Also the surgically induced astigmatism was assessed post operatively and keratometric readings compared between the two groups. There was no statistical difference between the two groups in term of induced astigmatism.
Conclusions: Micro MSICS is more cost effective, with no major complications, similar post operative astigmatism, provides early rehabilitation & good visual recovery with short learning curve.
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References
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