Phacoemulsification versus small incision cataract surgery in patients with uveitis

• 作者: Avinash Kaur Manoj Kumar Prachi Kumar Rahul Bhargava Shiv Kumar Sharma
• 来源期刊: 国际眼科杂志：英文版
• 学科: 医学
• 关键词: 小切口奔流外科 PHACOEMULSIFICATION 眼色素层炎 改正的距离视觉尖酸 未改正的距离视觉尖酸
• 年，卷（期）: 2015,（5）
• 页码范围: 965-970
• 页数: 0页
• 分类号: R779.66

摘要

AIM: To compare the safety and efficacy of phacoemulsification and small incision cataract surgery(SICS) in patients with uveitic cataract.·METHODS: In a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo(defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance(ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95%confidence interval(CI). A P value of <0.05 was considered statistically significant.·RESULTS: One hundred and twenty-six of 139 patients(90.6%) completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months(n=1) or inability implant an intraocular lens(IOL) because of insufficient capsular support following posterior capsule rupture(n=5). There was significant improvement in vision after both the procedures(paired t-test; P <0.001). On first postoperative day, uncorrected distance visual acuity(UDVA) was 20/63 or better in 31(47%)patients in Phaco group and 26(43.3%) patients in SICS group(P=0.384). The mean surgically inducedastigmatism(SIA) was 0.86 ±0.34 dioptres(D) in the phacoemulsification group and 1.16 ±0.28 D in SICS group. The difference between the groups was significant(t-test, P =0.002). At 6mo, corrected distance visual acuity(CDVA) was 20/60 or better in 60(90.9%) patients in Phaco group and 53