Annapurani, - (2008) Intra operative complication and visual outcome following phacoemulsification in posterior polar cataract. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: During the past two decades the advances in cataract surgery have not only been phenomenal but have also been gratifying to both the surgeon and the patient, especially to those patients who present with very early cataractous changes but with significant visual symptoms hindering normal day-to-day life. At present Phacoemulfication has been rapidly established as a widely accepted means of cataract removal. Even though it has improved over the years, there are various complication encountered during this procedure like the posterior capsular rupture with loss of nucleus into vitreous. Posterior Polar Cataract presents a special challenge to the phacoemulsification surgeon because these eyes have a predisposition to posterior capsule dehiscence during the surgery. It is an important type of developmental cataract that affects vision in its early course. The lens may have evidence of a small opacity at birth but the cataractous changes take place later in life usually in the late 30`s or early 40`s. Hence surgery is very much warranted in such visually symptomatic early cataracts. Cataract surgery using current phaco techniques offers a number of attractive benefits to both the surgeon and the patient. The principle advantage is a smaller incision size, which decrease the amount of tissue injury, reduces the amount of post operative pain & inflammation & provides more rapid refractive stabilization with less astigmatism than other procedures performed before. AIMS AND OBJECTIVES: To study the intraoperative complications encountered during phacoemulsification procedure in Posterior Polar Cataract. To study the Visual outcome following the Phacoemulsification procedure in Posterior Polar Cataract. MATERIALS & METHODS: Prospective clinical study of 30 consecutive patients with Posterior Polar Cataract who underwent Phacoemulsification was done from October 2005 to August 2007. The detailed preoperative evaluation included: •Recording uncorrected, best corrected and pin hole visual acuity using snellen`s chart. •Detailed slit lamp evaluation with dilated pupils was performed and all typical cataracts with Bull’s eye appearance were taken up into the study. Congenital posterior capsular dehiscence was looked for during slit lamp examination. •Other work up included intraocular pressure, Fundus examination, A scan & keratometry done. Under peribulbar & facial block all the cases were operated by phacoemulsification procedure. SUMMARY OF RESULTS: 1). Majority age of presentation is 45 – 65 years (63.33%). 2). Predominant sex were Males (70%). 3). Equal presentation of Right and Left eyes. 4). Percentage of PCR (13.34%) [4 cases out of 30 eyes]. CPCD (3.33%) [1 cases out of 30 eyes]. In 3 cases PCR occurred during Phacoemulsification of nucleus, In 1 cases PCR occurred during Cortex removal. 5). Marked visual improvement post operatively in 93.34% of cases. (28 out of 30 eyes). Post operative vision improved in 28 cases, 1 case remained same due to amblyopia, 1 case deteriorated due to thick PCO. DISCUSSION: Cataract surgery in Posterior polar cataract is challenging and many a times scary for the surgeon because of its predisposition to posterior capsular rupture or dehiscence. PPC is a type of development cataract which affect vision quite early causing significant glare and blurred vision otherwise. In our study the age of patient varied from 25-65 years which clearly indicates that the study group included both the stationary and progressive type of PPC. There was a clear cut male preponderance in our study which does not mean the non involvement of other sex. The probable reason for this preponderance in our country may be that the females are usually confined indoors and males remains outdoors for longer time encountering more glare consistently. CONCLUSION: Phacoemulsification in PPC is feasible and a good technique with all the necessary precautionary steps properly adopted. One has to always do a clear counselling to the patient explaining the type of cataract and the complication expected. The surgeon has to anticipate and try to prevent untoward complication rather than encountering and managing them. (Prevention is always better than cure).
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | posterior polar cataract ; phacoemulsification ; visual outcome ; intra operative complication |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Devi S |
| Date Deposited: | 21 Sep 2017 09:23 |
| Last Modified: | 21 Sep 2017 16:10 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3243 |
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