|Year : 1989 | Volume
| Issue : 4 | Page : 205-206
Phaco-emulsification aspiration procedure : An evaluation
AK Srivastava, MK Mehra, J Agarwal, S Vishnoi
A-965/8, Indira Nagar, Lucknow-226 016, India
A K Srivastava
A-965/8, Indira Nagar, Lucknow-226 016
Source of Support: None, Conflict of Interest: None
The results phaco-emulsification aspiration procedure have been evaluated in 50 cataract patients, by observing the final visual acuity achieved and astigmatic error induced, along with incidence of various operative and post-operative complications. Majority of the patients who did not have serious preoperative complications achieved good vision. The procedure has proved to be equally effective for cataracts occurring in the younger age group.
|How to cite this article:|
Srivastava A K, Mehra M K, Agarwal J, Vishnoi S. Phaco-emulsification aspiration procedure : An evaluation. Indian J Ophthalmol 1989;37:205-6
| Introduction|| |
Phaco-emulsification aspiration procedure has been a major advance in the technique of extracapsular cataract operation. This procedure involves the use of ultrasound for softening and fragmenting the lens nucleus, thus enabling it to be aspirated. As the fragmentation, irrigation and aspiration are being done by a single probe, only a 2-3' mm incision in needed. This helps in rapid ambulation and visual rehabilitation of the patient. In the present study, the use of phaco-emulsification aspiration procedure has been evaluated in the treatment of various types of cataracts, occuring in patients of the younger age group, by observing the final visual acuity achieved and astigmatic error induced, along with the incidence of various operative and post-operative complications.
| Material and methods|| |
We have evaluated the results of phaco-emulsificationaspiration procedures in fifty cases of various types of cataracts. The majority of cases were congenital and traumatic cataracts [Table - 1]
Out of the total of 50 cases, the maximum number of procedures were done in the age group below 10 years (29 cases) while only 2 cases were in the age group above thirty years [Table - 2]
Various pre-operative complications, which already existed in the eyes to be treated by this procedure, are listed in [Table - 3]. These serious complications were likely to interfere with the final visual outcome.
The patients were subjected to a detailed history and examination both general and local. Local examination included slit lamp examination, measurement of intraocular tension, A-scan ultrasonography and keratometry.
The Cavitron-Kelman phaco-emulsifier aspirator (Model 8000) was used along with a Zeiss operating zoom microscope in all cases. Post-operatively, patients were watched for any complications. Follow up was done evry week.
| Observations|| |
[Table - 4] shows the various operative complications. Accidental rupture of the posterior capsule occured when extensive cleaning of the posterior capsule was tried.
[Table - 5] shows the various post-operative complications with this procedure. Subsequent needling i.e., delayed capsulotomy was needed in 4 out of 5 patients who developed significant opacity of the posterior capsule during the post-operative follow-up. [Table - 6] depicts the final visual acuity achieved by the patients. Out of the 50 patients, 2 patients had preperative complications (Viz., corneal opacity, microphthalmos, nystagmus and squint) which interfered with their final visual outcome. Only 30 patients had a sound ocular condition preoperatively. out of these 30 patients, 15 patients (50 %) achieved visual acuity of 6/12 or better, 10 patients (33.3%) had visual-acuity of 6/18 and only 5 (16.7%) had 6/36 or less. Out of these 4 patients were benefited by a subsequent needling. Only one patient got worse due to post-operative complication. Post-operative keratometry done at weekly intervals showed that in majority of the patients the amount of induced astigmatism was 0.25D or less. No patient developed astigmatic error of more than 0.5D. The keratometric findings become stationery after the third post-operative week.
| Discussion|| |
Visual results obtained in this series are more or less similar to those shown by Cleasby  .60% of his first 100 patients achieved visual acuity of 6/9 or better. Coltier  observed that 83% of 54 cases with no pre-operative pathology achieved a final visual acuity of 6/12 or better. Thus, the visual results obtained by this procedure are equivalent to those expected by conventional cataract surgery.
A small limbal incision used in this procedure has led to the following adventages.
(i) decreased incidence of post-operative complications like hyphaema and shallow anterior chamber. (ii) reduction in amount of induced astigmatism. (iii)rapid visual rehabilitation as the keratometric finding became stationary after the third post-operative week. The results of this procedure have proved that it is relatively safe and effective operation. 78% of all cases in this study were below 20 years of age. Previously, procedures like needling or curette evacuation were being performed on younger patients having cataract. With the advent of phaco-emulsification, it has become possible to remove even the hard lens matter more completely, with comparatively more success and much ease. Thus, it should definitely be the operation of choice for the removal of cataracts from the eyes of children and young adults.
| References|| |
Kelman, CD.: Am J. Ophth. 75:764,1973
Cleasby, et al: Am. J. Ophth. 77.384, 1974.
Coltier, E Rose, M.: Trans. Am: Acad. Ophth. Oto L ar,81:op.
Paul, AK.: Ind. J. Ophth. 27:47,1979.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5], [Table - 6]