Visual outcome and complications of manual sutureless small incision cataract surgery - A rural hospital based study

Abstract

Aims and Objectives: To determine the surgically induced astigmatism and complications of Manual Sutureless Small Incision Cataract Surgery. Final Best Spectacle Corrected Visual Acuity at 3months. Material and Methods: This randomized prospective interventional study conducted in the Department of Ophthalmology, Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi Meghe,Wardha, Maharashtra. This study was approved by 'The Ethical Committee DMIMS (DU), Nagpur.' In this study 200 Eyes of 200 Patients were included. The study was conducted 1st Sept 2011 to 1st Sept 2012. Cataract surgery was performed in all cases by manual sutureless small incision technique. Patients were thoroughly examined and visual acuity & Keratometry were recorded pre-operatively and at follow-up visits. The type and amount of astigmatism were calculated from the Keratometry readings. Any complications found during surgery or on follow up visits were also recorded. Results: Out of 200 patients, 108(54%) patients achieved BSCVA of 6/6 and 61(30.5%) patients having BSCVAof 6/9 with no patients having BSCVAless than 6/ 18. Astigmatism was noted to be significant or high and was comparable with phacoemulsification technique. In our study, 54 patients developed complications in which, 23(11.5%) patients developed Striate Keratopathy, 20 (10%) developed corneal oedema, 11(5.5%) patients had increased IOT, 4(2%) with Descemets Stripping and 2(1%) with wound leak. Also we found 6(3%) patients with post op anterior segment inflammation and 3 (1.5%) patients with intra operative hyphema. Conclusions: Manual small incision cataract surgery is able to achieve excellent outcomes, less learning curve and fewer complications along with lower cost and average surgical time than phaco. Post-operative astigmatism is less and comparable with phaco. Final BSCVA was good in almost all cases. Cost required for this is far less than phaco.