Suresh Ramanarao Addagarla

Abstract

Introduction: An uneventful cataract surgery with intraocular lens implant is capable of providing normal vision. Good visual outcome increases patient’s satisfaction and quality of life. Aim is to evaluate the postoperative complications and visual outcomes after manual small incision cataract surgery at a teaching hospital. Materials and Methods: In this study 100 patients who underwent uneventful SICS with PCIOL implant were followed up. Patients having pre-existing ocular disease were excluded. IOL power was accurately estimated. Visual acuity, anterior segment and fundus findings were recorded at each postoperative visit upto 6 weeks and in some cases upto 3months. We followed the visual outcome standards set by WHO. Results: 53 males and 47 females in the age group of 45 to 75 and above were selected. On 1st post operative day 38% patients had quiet eyes. In 62% patients, decreased vision and complications observed on 1st post operative day and upto 1st week were: Striate keratopathy and corneal edema, anterior uveitis with pupillary membrane, residual lens matter, macular edema, endophthalmitis, intraocular hemorrhage with secondary glaucoma and IOL related causes. On the 6th postoperative week during spectacles prescription, 60% had uncorrected Astigmatism, 5% consecutive myopia/ hypermetropia and 8% had posterior capsular opacity. At 3 months follow up, 92% had good outcome, 3% patients had borderline outcome. 5% poor visual outcome was seen in patients with Bullous keratopathy, endophthalmitis, vitreous hemorrhage and longstanding macular edema. Conclusion: Our hospital based study reports 5% patients with poor visual outcome 3 months after uneventful cataract surgery. Keywords: Astigmatism, Complications, Small incision cataract surgery, Uneventful, Visual outcome.

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Abstract

Introduction: Secondary Glaucoma is a group of disorders in which raised intraocular pressure is associated with some primary ocular or systemic cause. This prospective study aims to evaluate the various commonly seen causes of secondary glaucoma. Materials and Methods: A total of 50 patients with raised intraocular pressure coming to a teaching hospital during a period of three years were studied. Patients with primary glaucoma were excluded from this study. Clinical evaluation was done in all the cases and the visual acuity, intraocular pressure and the optic nerve head changes were recorded. The various age groups and the gender distribution were noted. Also history of diabetes, hypertension and trauma was specifically asked for. Results: Out of 50 patients, a total of 29 (58%) patients were above 60 years of age. Predominantly 28 (56%) were male patients. Visual acuity was less than 3/60 in 34 (68%) of all patients. The mean intraocular pressure recording was 34 mm of Hg, within a range of 21 to 46 mm of Hg. Only 23 (46%) patients showed optic neuropathy. The most common causes were lens induced glaucoma seen in 24 (48%) cases and next 14% each seen in neovascular glaucoma and pseudoexfoliative glaucoma. Diabetes and/or Hypertension were present in 8 (16%) patients. Conclusion: This study identifies ocular factors like cataracts in lens induced glaucoma, age factor in pseudoexfoliative glaucoma and systemic factors like diabetes and/or hypertension in neovascular glaucoma, and also emphasizes that the prompt detection of these causes can prevent severe visual impairment. Keywords: Age, Diabetes, Lens induced glaucoma, Secondary glaucomas.

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