|Year : 1982 | Volume
| Issue : 5 | Page : 449-450
One day cataract
BT Maskati, RP Tehangir
Deptt. of Ophthalmology, K.E M. Hospital, Mumbai, India
B T Maskati
Deptt, of Ophthalmology K.E.M. Hospital, Mumbai-400 012
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Maskati B T, Tehangir R P. One day cataract. Indian J Ophthalmol 1982;30:449-50
The increasing success in cataract surgery in recent years has largly been due to the technical improvements in surgical instruments, fine sutures and a better understanding of the factors leading to the fortunately small percentage of post operative complications. With this increasing successful average, many surgeons have begun to question the validity for keeping the patient in hospital for a week as well as for restricting their activities in the first several weeks following surgery. With the above principles in mind a series of fifty cataract operations were performed at the K.E.M. Hospital Bombay, by two experienced surgeons. All the patients were discharged the following day, half of them with dark glasses and the other half with a pad and bandage and a regular follow up was maintained.
| Materials and methods|| |
1. Criteria of Selection A patient with a normal sensorium, a patient whose dwelling place was a little better than the general ward of the hospital in all respects and who was fully functional was considered as a suitable candidate.
All the patients were subjected to usual preoperative check-up. The presence of controlled cardiac disease, diabetes or other systemic disease in a functional patient was not considered a contra indication to immediate ambulation of the patient postoperatively and early discharge from the hospital.
A series of 50 patients were operated under local anaesthesia since May 1980. All cases had a knife section, one pre-placed and four post-placed (8-0) silk sutures. Peripheral button hole iridectomy intracapsular extraction with cryo. One eye pad was given after surgery and ail movements were allowed six hours after surgery.
Observations Total number of cases operated 50 was Level of visual acuity attained was 6/6 vision-14 Cases 6/9 vision-24 Cases and 6/12 vision-12. Cases the Complications Seen were as under :
(I) Wound gape-Nil
(2) Iris prolapse-Nil
(4) Flat anterior chamber with secondary glaucoma-One
(5) Choroidal detachment-One
Vitreous face six weeks following operation was in anterior chamber in 16 cases and vitreous posterior to Iris diaphragm in 34 cases.
| Discussion|| |
Many currently active Ophthalmologists remember when postoperative cataract patients suffered sand-bagging of their heads.
The same practitioners have watched and adopted sclero-corneal suturing with earlier and earlier ambulation. They have watched postoperative hospitalization decrease from several weeks to several days to now a single day.
Julian Chrisholm, Professor of Ophthalmology at the University of Maryland in 1866 wrote that his post operative cataract patients walked to their rooms with no restriction of movements. Christy in Pakistan reported on the complications following 3000 cataract extractions, one thousand patients were kept in bed for 8 days, another one thousand for one day and the other one thusand walked from the operating table to their beds with no restriction of activities, of each group 949 of the patients obtained good visual results, there being essentially no difference in post operative complications in the three groups. In 1973 in New York city a retrospective study involving 1000 patients, Galin demonstrated that immediate ambulation and discharge after cataract surgery yielded results exactly comparable to those obtained with hospitalized patients.
| Summary|| |
Fifty patients with senil uucomplicated cataracts were hospitalized for one day only after operation. 25 patients were discharged with pad on the operated eye and 25 with goggles. They were called for follow-up on alternate days for one week, then once a week for two weeks and later fortnightly.
This study is conducted to assess the advantages and disadvantages of earthy ambulation. The patients were selected from good socio-economic status as per a proforma prepared seeking details of their home spaces, hygiene, etc.
The surgery was performed by Senior Ophthalmic Surgeons. Knife section with five 8/0 silk sclero corneal sutures were applied and lens extracted with a cryo probe.
The present study has shown that early ambulation is as good as one week hospitalization in properly selected cases.