Corneal endothelial cell loss with different techniques of nucleus delivery in Manual Small Incision Cataract Surgery- Randomized Controlled Trial.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Journal of cataract and refractive surgery Pub Date : 2024-12-24 DOI:10.1097/j.jcrs.0000000000001605

Fincy Mol, Swathi Nagarajan, Rajalakshmi Ar, Ezhumalai Govindasamy

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引用次数: 0

Abstract

Purpose: To compare corneal endothelial loss in manual small incision cataract surgery (MSICS) following three different techniques of nucleus delivery (Viscoexpression, Irrigating Vectis, Phacosandwich).

Setting: Mahatma Gandhi Medical College and Research Institute, Puducherry, India.

Design: Prospective, single blinded, randomized controlled trial.

Methods: Willing patients > 40years of age with immature cataract and posted for MSICS were recruited for the study. Those with systemic or ocular comorbidities which may influence corneal endothelium, dilated pupil size of <5mm, intraoperative complications and postoperative corneal haze were excluded. They were randomly divided to one of the three groups (Group 1- Viscoexpression, Group 2- Irrigating Vectis, Group 3- Phacosandwich) for nucleus delivery. Visual acuity and corneal endothelial parameters were recorded preoperatively and postoperatively at 6-8weeks.

Results: A total of 90 patients with mean age of 59.13 ± 9.42 years (range 40-82years) were studied with 30 patients in each group. Following MSICS there was a 12.12% (p=0.001) endothelial cell loss. It was 10.81% in viscoexpression group, 11.3% in irrigating vectis group and 14.28% in phacosandwich group. Post hoc analysis with Dunn Bon ferroni test showed endothelial cell loss following viscoexpression and irrigating vectis methods of nucleus delivery were comparable (p=0.096) and significantly lesser (p<0.001) than in Phacosandwich group.

Conclusion: There was significant endothelial cell loss following MSICS. Nucleus delivery by viscoexpression and irrigating vectis had similar endothelial cell loss while it was greater with phacosandwich technique.

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人工小切口白内障手术中不同送核技术角膜内皮细胞丢失-随机对照试验。

目的：比较手工小切口白内障手术（msic）中三种不同的送核技术（Viscoexpression, perfusion Vectis, phacossandwich）的角膜内皮损失。地点：印度普杜切里圣雄甘地医学院和研究所。设计：前瞻性、单盲、随机对照试验。方法：招募年龄在40 ~ 40岁之间的未成熟白内障患者，自愿接受msic治疗。结果：共纳入90例患者，平均年龄59.13±9.42岁（40 ~ 82岁），每组30例。mscs术后内皮细胞损失12.12% （p=0.001）。粘表达组为10.81%，灌胃组为11.3%，三明治组为14.28%。Dunn Bon ferroni试验的事后分析显示，粘表达后的内皮细胞损失与灌流载体送核方法相当（p=0.096），且明显更少(p结论：mscs后内皮细胞损失明显。粘表达法和灌胃法传递细胞核内皮细胞损失相似，而夹心法更大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

$Journal of cataract and refractive surgery$

Journal of cataract and refractive surgery 医学-外科

CiteScore

5.60

自引率

14.30%

发文量

259

审稿时长

8.5 weeks

期刊介绍： The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS). JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.