RESUMO
Purpose: To evaluate various methods of nucleus delivery in manual small incision cataract surgery, with reference to visual outcome, intraoperative, and postoperative complications. Methods: In this prospective randomized interventional study, five groups of 40 cases each were constituted, with reference to nucleus delivery technique: (a) phacosandwich, (b) fishhook, (c) irrigating vectis, (d) viscoexpression, and (e) anterior chamber maintainer (ACM). Visual outcome, intraoperative, and postoperative complications were evaluated in detail. Follow-up was done on first and seventh postoperative days (PODs) and then at fourth and eighth postoperative weeks. Results: The most common intraoperative complication was intraoperative miosis, followed by intraoperative hyphema, seen more in phacosandwich and irrigating vectis groups. The most common postoperative complication was striate keratopathy followed by transient postoperative corneal edema and AC inflammatory response, seen more in phacosandwich and fishhook groups. With reference to visual acuity, on the first POD 95% cases of ACM group achieved visual acuity >+0.5 logMAR unit. The difference in the visual outcome among groups was statistically significant. On fourth and eighth postoperative weeks, best-corrected visual acuity among various groups was comparable. Conclusion: ACM and viscoexpression are effective techniques for early visual rehabilitation. Fishhook has limited utility in softer nuclear grades and black cataracts. Phacosandwich is more suitable for nuclear sclerosis Grades 3–4. Irrigating vectis, viscoexpression, and ACM technique are effective techniques for all grades of nucleus Postoperative surgical-induced astigmatism was comparable in all techniques.
RESUMO
Introduction. Injuries caused by fishing gear are common, but uncommon in the eye.When hooks are involved, removal must be careful and a complete revision of the rest of eye structures must be performed. Case report. A 13 years old male suffered a penetrating fishhook injury on the upper right eyelid. Extraction was performed under general anesthesia using an extra conjunctival horizontal technique approach with satisfactory outcome. Conclusion. The injuries caused by these objects are dangerous and extraction must be carefully done. A multidisciplinary approach must be performed.
Introducción. Las lesiones por objetos de pesca son comunes, no así en ojos y anexos. Su extracción debe ser cuidadosa y deberá realizarse revisión minuciosa de las estructuras afectadas. Caso clínico. Adolescente masculino de 13 años de edad que accidentalmente sufrió una herida penetrante por anzuelo en párpado superior derecho. Se realizó extracción bajo anestesia general balanceada mediante abordaje palpebral horizontal extraconjuntival, con evolución satisfactoria. Conclusiones. Las lesiones por estos objetos son graves y su manejo debe ser integral.