Comparative evaluation of visual acuity and complications in ECCE+P/C IOL and phacoemulsification+ P/C IOL in Senile Cataract

ABSTRACT

The age related cataract surgery is most common ophthalmic surgery. Today the method of choice for cataract surgery is phacoemulsification. This study was conducted to compare the visual acuity, pre-operation and post operation ECCE and Phacoemulsification complication in patients referring to Khalili and Dastgheib Hospital in Shiraz during 1380-1381. This prospective non randomized concurrent control study was conducted on 100 cases [52 case of ECCE and 48 case of Phaco]. Pre-operative evaluation included age, sex, visual acuity, astigmatism according to keratometry difference and type of cataract. The patients were evaluated during the operation for size, site of incision, posterior capsular rupture, vitreous loss and nucleus dropped in vitreous. Then in 1, 5, 14, 90,180 days post operation, they were examined for BCVA, UNCVA, astigmatism [keratometry and refraction], inflammation, corneal edema, posterior capsular opacity and clinical CME. In this study 100 cases [48 phacoemulsification, 52 ECCE] aged 48-76 for cataract surgery were included. Patients were followed for 6 months after operation. Mean age in phacoemulsification was 58.27 +/- 7.26 and in ECCE was 64.71 +/- 6.84. On the fifth day after ECCE, UNCVA >/= 30.60 was 15.3% and in phaco was 62.5%. On the fifth day mean UNCVA in phaco was 30.60 and in ECCE, 20.60. Mean astigmatism on the first day post-operation according to keratometry difference in ECCE was 4.84 +/- 2.08D and in phaco was 2.27 +/- 1.67D and according to refraction in ECCE was 3.62 +/- 2.08D and in phaco was1.91 +/- 1.34D. Posterior capsular rupture in ECCE was 7.6% and in phaco was 12.5%. Vitreous loss in ECCE was 5.7% and in phaco was 10.7%. Corneal edema in the first day post-operation in ECCE was 19.2% and in phaco was 43.8%. Two weeks after operation in all patients who underwent phacoemulsification, corneal edema was cleared, but in ECCE 3.8% corneal edema continued for 6 months after operation. Nucleus dropped in vitreous occurred only in phaco [2.1%] IOL dislocation after phacoernulsification was 4.1% and 2.1% [1 case] need to IOL removal, but this complication was not visible in ECCE. Success rate, Intra operative and post-operative complications in phacoernulsification in comparison to other studies were in an acceptable range. We recommend further study in this case for more documented results: