Jaya Devendra1, Smita Agarwal2, Pankaj Kumar Singh3. 1. Associate Professor, Department of Ophthalmology, Rohilkhand Medical College and Hospital , Bareilly, India . 2. Associate Professor, Department of Ophthalmology, Teerthankar Mahavir Medical College , Moradabad, India . 3. Associate Professor, Department of Anatomy, Rohilkhand Medical College and Hospital , Bareilly, India .
Abstract
CONTEXT: Low socio-economic group patients from rural areas often opt for free cataract surgeries offered by charitable organisations. SICS continues to be a time tested technique for cataract removal in such patients. In recent times, camp patients are sometimes treated by clear corneal phacoemulsification with implantation of a rigid IOL, which being more cost effective is often provided for camp patients. This study was undertaken to find out which surgical technique yielded better outcomes and was more suited for high volume camp surgery. AIM: To find the better surgical option- phacoemulsification with rigid IOL or SICS, in poor patients from rural areas. SETTINGS AND DESIGN: A prospective randomised controlled trial of cataract patients operated by two different techniques. MATERIALS AND METHODS: One hundred and twelve eyes were selected and were randomly allocated into two groups of 56 eyes each. At completion of the study, data was analysed for 52 eyes operated by clear corneal phacoemulsification and implantation of a rigid IOL, and 56 eyes operated by SICS. STATISTICAL ANALYSIS USED: Unpaired t-test was used to calculate the p- value. RESULTS: The results were evaluated on the following criteria. The mean post-operative astigmatism at the end of four weeks - was significantly higher in phacoemulsification group as compared to SICS group The BCVA (best corrected visual acuity) at the end of four weeks - was comparable in both groups. Subjective complaints and/ or complications: In phaco group two patients required sutures and seven had striate keratitis , while none in SICS group. Complaint of irritation was similar in both groups. Surgical time- was less for SICS group as compared to phaco group. CONCLUSION:SICS by virtue of being a faster surgery with more secure wound and significantly less astigmatism is a better option in camp patients from rural areas as compared to phacoemulsification with rigid IOL.
RCT Entities:
CONTEXT: Low socio-economic group patients from rural areas often opt for free cataract surgeries offered by charitable organisations. SICS continues to be a time tested technique for cataract removal in such patients. In recent times, camppatients are sometimes treated by clear corneal phacoemulsification with implantation of a rigid IOL, which being more cost effective is often provided for camppatients. This study was undertaken to find out which surgical technique yielded better outcomes and was more suited for high volume camp surgery. AIM: To find the better surgical option- phacoemulsification with rigid IOL or SICS, in poor patients from rural areas. SETTINGS AND DESIGN: A prospective randomised controlled trial of cataractpatients operated by two different techniques. MATERIALS AND METHODS: One hundred and twelve eyes were selected and were randomly allocated into two groups of 56 eyes each. At completion of the study, data was analysed for 52 eyes operated by clear corneal phacoemulsification and implantation of a rigid IOL, and 56 eyes operated by SICS. STATISTICAL ANALYSIS USED: Unpaired t-test was used to calculate the p- value. RESULTS: The results were evaluated on the following criteria. The mean post-operative astigmatism at the end of four weeks - was significantly higher in phacoemulsification group as compared to SICS group The BCVA (best corrected visual acuity) at the end of four weeks - was comparable in both groups. Subjective complaints and/ or complications: In phaco group two patients required sutures and seven had striate keratitis , while none in SICS group. Complaint of irritation was similar in both groups. Surgical time- was less for SICS group as compared to phaco group. CONCLUSION: SICS by virtue of being a faster surgery with more secure wound and significantly less astigmatism is a better option in camppatients from rural areas as compared to phacoemulsification with rigid IOL.
Authors: P K Nirmalan; R D Thulasiraj; V Maneksha; R Rahmathullah; R Ramakrishnan; A Padmavathi; S R Munoz; L B Ellwein Journal: Br J Ophthalmol Date: 2002-05 Impact factor: 4.638