An Analytical Study of Astigmatism in Relation to SICS (Small Incision Cataract Surgery)

Dr. (Mrs.) Chhaya Shori, Dr. Rakesh Shori

Govt. Medical College, Jagdalpur (CG)

*Corresponding Author E-mail: drrakesh.shori@gmail.com, drchhaya.shori@gmail.com

ABSTRACT:

Aims and Objective:

To analyze the Keretometric changes occurred after SICS (small incision cataract surgery)

Material and Methods:

This study was conducted in upgraded Department of Ophthalmology (Tertiary health care Hospital). A total of 50 cases selected were of senile immature cataract. There was no cases of other complication. A detailed present, post, family history, social history was obtained. All necessary examination and investigation were performed.

Statistical Analysis:

Required statistical analysis was done.

Observation and Discussion:

It was noted that incidence of Astigmatism was 26% with rule on 3^rd post operative day which decreased to 20% on 6^th post operative day. The cases operated by SICS showed against the rule astigmatism on 3^rd post operative day. The findings of the present study were more or less in accordance of other studies.

Conclusion:

The result of this study showed less post operative astigmatism and early visual rehabilitation. SICS has come as a boon to fill in this fawning gap in between high cost, high tech phacomachine and conventional cataract surgery.

KEYWORDS: Astigmatism, small incision cataract surgery.

INTRODUCTION:

It the past several years than have been dramatic improvement in phasoemulisification technology involving every aspect of phacoemulsification systems from the phaco tip all the way down to the foot pedal. Improvement in the generation of ultrasonic power, fluidics, vser interfaces and tips and hand pieces have been extremely advantageous to the cataract surgeon.

Astigmatism can be natural or surgically induced. Natural astigmatism is common upto 95% of eyes may have some clinically detectable astigmatism. In general population 10-20% can be expected to have natural astigmatism > ID with a quality of uncorrected visual acuity that might be considered unsatisfactory. About 3-10% of the general population has an astigmatism >2D following extra capsular cataract extraction is 25-30% (this incidence is lower after phacoemulsification is 25-30%) By taking into consideration the above facts, author had undertaken this study know the post operative astigmatism after small incision cataract surgery.

Material and methods:

A total of 50 patient suffering from senile immature cataract with no other complication were included in the study material.

Surgically induced astigmatism calculated by vector analysis method on 3^rd day, 7^th day, 2^nd week, 4^th week and 6^th week. Spectacle correction was given after 8^th week.

Observation and discussion:

On analysis of the collected data it was observed that the it was with rule, against rule and no astigmatism on 3^rd post operative day was 52%, 42% and 06% respectively (Table- I) which was changed in to 50%, 46% and 04% on 7^th post operative day. Table further reveals that on 2^nd week it changes to 52%, 42% and 6% and on further examination i.e. on 4^th week. It was 50%, 40% and 02% further examination on 6^th post operative week it found the percent was 54%, 40% and 06%.

Table – I

Follow up	Post operative Astigmatism in SICS
Follow up	No. (%)	With rule (%)	Against Rule (%)
3^rd day	03 (06)	26 (52)	21 (42)
7^th day	02 (04)	25 (50)	23 (46)
2^nd week	03 (06 )	26 (52)	21 (42)
4^th week	01 (02)	29 (58)	20 (40)
6^th week	03 (06)	27 (54)	20 (40)

Astigmatism Induced by surgery was calculated by post operative retinoscopy. 76% cases had less than 1D astigmatism and the remaining 24% had astigmatism of more than 2D.

M.H. Lunataz et al (1977) concluded the astigmatism after 6 week and 8 months after operation in 409 eyes and stated that corneal astigmatism was increased after operation with the nylon suture in place and dramatic drop in the magnitude of corneal astigmatism once the suture were removed.

Gonzalez – Grurefa (1980) used corneal incision and continuous sutures in cataract surgery. Astigmatism was measured pre operatively and 7, 20, 47, 60 and 90^th days after surgery in 81 eyes. In 30 eyes the difference of astigmatism was 0.5D or less , in 18 cases between 0.75 to 1.25D, in 20 cases between 1.5 to 2D, in 13 cases it exceeded 2.25D.

Nirankari et al (1968) reported in their study that the healing of corneal wound after cataract surgery invariably produced astigmatism against the rule.

The findings of the present study were more or less similar to the findings of the various study.

Conclusion:

One of the aims of small incision cataract surgery is minimal or no stigmatism. Astigmatic Keratometry can be used to modify the astigmatic outcome particular for against the rule astigmatism.

Reference:

1. Lunatez M.H. Afr. Med. J. 31, 475- 476 may 1957.

2. Gonzalez – Grureta, Arch SOC, PSP. Ophthalmol. 39: 21-28, Jn. 1979 cited in ophthal lit. vol. 33, No. -4, 2826, Sep 1980.

3. Mark M.V. (1957) : Opt. j. 94, 27-29 August.

4. Bedrossian P.B., Seboter G. and troutman R.C., Procist, 1^st, 8^th after int. ophthal, sunp 21- 225 (1968).

Received on 05.06.2015 Modified on 14.06.2015

Res. J. Pharmacology & P’dynamics. 7(2): April- June 2015; Page 101-102

DOI: 10.5958/2321-5836.2015.00020.8