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Viscoless Manual Small Incision Cataract Surgery with Trabeculectomy
Aparna Rao1, Debananda Padhy2, Gopinath Das2
1a Glaucoma Service , MTC Campus, LV Prasad Eye Institute , Bhubaneswar , Odisha , India.
Seminars in Ophthalmology
|July 1, 2017
Summary
Using an anterior chamber maintainer (ACM) significantly reduces surgical time in combined manual small incision cataract and glaucoma surgery compared to viscoelastics. This technique is effective in low-resource settings, improving patient outcomes.
Area of Science:
- Ophthalmology
- Surgical Innovation
Background:
- Combined cataract and glaucoma surgery aims to improve vision and reduce intraocular pressure.
- Traditional methods often involve intraoperative viscoelastics, which can increase surgical time and cost.
Purpose of the Study:
- To compare the efficacy of combined manual small incision cataract and glaucoma surgery using an anterior chamber maintainer (ACM) versus intraoperative viscoelastics.
Main Methods:
- Retrospective study of 147 patients undergoing combined MSICS and trabeculectomy.
- Comparison between group 1 (ACM alone) and group 2 (viscoelastics).
- Data analyzed included surgical time, intraoperative complications, and postoperative visual acuity and IOP.
Main Results:
- Significantly lower surgical time in the ACM group (16±4.8 min) compared to the viscoelastic group (44±14.6 min).
- Transient corneal edema was more frequent in the viscoelastic group.
- Both groups achieved >50% IOP reduction and improved visual acuity.
Conclusions:
- Anterior chamber maintainer (ACM) is an effective alternative to viscoelastics in combined MSICS and glaucoma surgery, reducing surgical time.
- This technique is particularly beneficial in low-resource settings.
- Incorporating ACM training into residency programs is recommended.