Safety and Efficacy of Bimanual Microincisional Cataract Surgery Under Anterior Chamber Maintainer in Senile Cataract Patients

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Safety and Efficacy of Bimanual Microincisional
Cataract Surgery Under Anterior Chamber
Maintainer in Senile Cataract Patients

• Özcan R. Kayikçioglu, Sinan Emre
• Celal Bayar University School of Medicine,
• Department of Ophthalmology, Manisa, Turkey

Authors have no financial interest
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Introduction

• Cataract surgery continues evolution
• Technological advances,
• Enhanced surgical techniques
• Smaller incision
• Improved refractive and visual outcomes
• Reduced intra postoperative complications

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Introduction

• Incision size reduction led to the development of
  microincisional cataract surgery (MICS)
• Cataract removal through 1.01.5 mm incisions
• Anterior chamber instability
• Anterior chamber maintainer (ACM) (?)

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Purpose

• To investigate the safety and efficacy of
  microincisional cataract surgery (MICS) combined
  with anterior chamber maintainer (ACM)

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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

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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

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Results

• 17 M (53.2 ) and 15 F (46.8)
• Mean age 63.89.7 (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)

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Results

• Preop. mean VA 0.180.16 ? 0.730.29 on 1m
• Preoperative mean IOP 14.23.5 and 14.13.6 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

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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

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Conclusion

• MICS combined with ACM was safe and efficient in
  senile cataract patients