Özcan R. Kayıkçıoğlu, Sinan Emre

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Presentation transcript:

Özcan R. Kayıkçıoğlu, Sinan Emre Safety and Efficacy of Bimanual Microincisional Cataract Surgery Under Anterior Chamber Maintainer in Senile Cataract Patients Özcan R. Kayıkçıoğlu, Sinan Emre Celal Bayar University School of Medicine, Department of Ophthalmology, Manisa, Turkey Authors have no financial interest San Francisco-ASCRS-2009

Introduction: Cataract surgery continues evolution Technological advances, Enhanced surgical techniques Smaller incision Improved refractive and visual outcomes Reduced intra & postoperative complications San Francisco-ASCRS-2009

Introduction: Incision size reduction led to the development of “microincisional” cataract surgery (MICS) Cataract removal through 1.0–1.5 mm incisions Anterior chamber instability Anterior chamber maintainer (ACM) (?) San Francisco-ASCRS-2009

Purpose: To investigate the safety and efficacy of microincisional cataract surgery (MICS) combined with anterior chamber maintainer (ACM) San Francisco-ASCRS-2009

Patients and Methods: 35 eyes of 32 patients with senile cataract Phaco with MICS under ACM and implantation of PC/ IOL ACM placed inferotemporally, capsulorhexis was performed as vacuum capsulorhexis under ACM Phaco performed through a 1.8mm incision Sleveless Sovereign Whitestar cold phaco Irrigating chopper ACM for better anterior chamber stability San Francisco-ASCRS-2009

Patients and Methods: Following bimanual cortical clean up, corneal incision was enlarged to 3mm and IOL implanted with an injector under ACM Intraoperative complications, BCVA, biomicroscopy, IOP and fundoscopy, preoperatively, 1 day, 1week and 1 month were recorded and reviewed San Francisco-ASCRS-2009

San Francisco-ASCRS-2009

Results: 17 M (53.2 %) and 15 F (46.8%) Mean age: 63.8±9.7 (42-83) years 21 /14 : R /L eyes (60% and 40%) Cataract type: Nuclear in 18 (51.4%) PSC in 5 (14.3%) Nuclear and cortical in 3 (8.6%) Posterior subcapsular and cortical in 3 (8.6%) White mature in 3 (8.6%) Posterior subcapsular and nuclear in 2 (5.7%) Posterior polar in 1 (2.8%) San Francisco-ASCRS-2009

Results: Preop. mean VA: 0.18±0.16 ↑ 0.73±0.29 on 1m Preoperative mean IOP 14.2±3.5 and 14.1±3.6 mmHg on 1 d No early postoperative IOP rise Postoperatively 8 (22.9%) patients had corneal edema which disappeared on 1 m No posterior intraoperative posterior capsular break or vitreous loss, no wound burn DR &AMD most frequent retinal problems 28.5% San Francisco-ASCRS-2009

Discussion: ACM: Improves anterior chamber stability Maintains wound temperatures below the threshold for thermal injury Keeps away the posterior capsule Decreased postoperative inflamatory mediators Economy San Francisco-ASCRS-2009

Conclusion: MICS combined with ACM was safe and efficient in senile cataract patients San Francisco-ASCRS-2009