ABSTRACT
Cataract, the leading cause of blindness in the world, is treated with surgery, and is the most common eye surgery performed. A PubMed search was done to review the spectrum of practice of cataract surgeries in Asian countries. Coverage for surgeries varied in different countries which depends mainly on the surgical facilities available in the region or country. Outreach programs, free surgeries and reimbursement of transport influence this. The cost of cataract surgery depends on type of cataract operation, government/private hospital, and facilities provided in the hospital, day care/in patient surgery, and economic status of people in the region/country. Phaco surgery was more expensive than extracapsular cataract extraction (ECCE) and manual small incision cataract surgery (SICS). Intracapsular cataract extraction (ICCE) was cheaper than ECCE in India. Local anaesthesia (retrobulbar, peribulbar, subtenon and topical) is used compared to general anaesthesia. Pain was more in topical compared to regional anaesthesia though no pain was reported for phacoemulsification under topical. Several manouveres have been utilised in difficult cases to optimise the outcomes. These include invention and modification of instruments, phacodynamic settings and surgical techniques. Specific regimes for pupillary dilatation have been recommended. In Diabetics, trenching was difficult. Elimination of cotton balls reduced fibres in the anterior chamber. Innovations in intraocular lenses (IOL) are glued IOL, Artisan iris fixated IOL, intrascleral fixation of IOL with Y sutures. Visual outcomes varied based on techniques of surgeries and types of IOLs used. The advancement of techniques and instrumentation has benefited patients with cataracts by improving outcomes.
ABSTRACT
AlM: To study an approach to visual acuity correction after intracapsular cataract extraction by phase - ll intraocular lens implantation through the individualized arcuate keratotomy. METHODS: For demonstration, 48 postoperative patients ( 50 eyes ) receiving the intracapsular cataract extraction were gathered up. Each patient received a scleral tunnel major incision along the radial line of the maximum corneal refractive power determined by a cornea curvimeter, and a arcuate keratotomy was made opposite to the major one; through the major incision an iris-claw intraocular lens is implanted. Each patient was measured for their corneal astigmatism and uncorrected visual acuity before and after the surgery. RESULTS: The results suggested the average corneal astigmatism before the surgery and that 3d, 1, 3, 6 and 12mo after the surgery as+3. 18±0. 68,-1. 56±0. 73,+0. 87± 0. 51, + 1. 21 ± 0. 70, + 1. 33 ± 0. 68 and + 1. 48 ± 0. 48 respectively. The uncorrected visual acuities 3d, 1, 3, 6 and 12mo after the surgery are 0. 5±0. 38, 0. 56±0. 23, 0. 55± 0. 24, 0. 52±0. 28 and 0. 51±0. 25 respectively. CONCLUSlON: Phase-ll intraocular lens implantation witharcuate keratotomy is helpful to improve the postoperative visual acuity and reduce preoperative corneal astigmatism after the intracapsular cataract extraction aphakic eyes, lt is also a low-cost surgery, and easy to perform, with minor surgical injuries, particularly available for surgical visual acuity correction of the aphakic eye receiving intracapsular cataract extraction.