Loupe magnification for small incision cataract surgery--an alternative to microscope magnification?

A Prospective randomized controlled study was conducted to compare outcome of Small Incision Cataract Surgery (SICS) using microscope or loupe magnification. Two hundred fifty one patient with mature cataract were randomly allocated to SICS-Fishhook Technique with either microscope (127 eyes) or loupe (124 eyes) magnification. Intra- and postoperative complications and immediate visual outcome were analyzed. Nearly two third (microscope 65% and magnifying loupe 62.9%) of all patients had good visual outcome on first postoperative day. Poor outcome (<6/60) was recorded in 8% (microscope group) and 7% (magnifying loupe group). Mean visual acuity with Snellen was 0.39 (SD 0.2) in microscope group and 0.38 (SD 0.2) in magnifying loupe group. Intra operative complications were comparable in both groups. Mean surgery time with loupe magnification was significantly shorter. Comparatively equivalent good surgical outcome was achieved with loupe as well as with microscope magnification. However performing SICS with loupe magnification is significantly faster. Small incision cataract surgery with loupe magnification is safe and effective procedure for cataract surgery so it can play a role in reducing cataract blindness in developing countries of the world.

Explantation of damaged foldable acrylic lens with implantation of foldable intraocular lens without enlarging incision.

Phacoemulsification with foldable intraocular lens (IOL) implantation has several advantages because of smaller incision and sutureless technique. The visual recovery is usually fast and any surgically induced astigmatism can be kept at lowest. With increased number of trained phacosurgeons in Nepal, more phacosurgeries with foldable lens implantation are being done. Main purpose of this article is to share our experience with ophthalmic surgeons about the technique of explantation and exchange of foldable hydrophilic acrylic lens with good visual outcome in the post operative period. This article describes a case of damaged intraocular lens within the capsular bag. This was successfully managed by snapping the lens into several pieces and explanting the same lens without enlarging the incision. Explantation of lens was followed by implantation of a new foldable lens with good surgical outcome.