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Indian Journal of Clinical and Experimental Ophthalmology


To compare the Gonioscopic changes in the angle after conventional ECCE with PC IOL implantation and Small Incision Cataract Surgery with PCIOL


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Author Details: Divya. N, Xavier Jayaseelan. C, Bindu Bhaskaran

Volume : 3

Issue : 3

Online ISSN : 2395-1451

Print ISSN : 2395-1443

Article First Page : 380

Article End Page : 383


Abstract

Introduction: To observe and compare the Gonioscopic changes in the angle after
·         Conventional ECCE with PC IOL implantation
·         Manual Small incision Cataract Surgery with PCIOL implantation
An attempt has been made to note the progression of these changes and the possible effects of these changes over the Intra Ocular Pressure and Postoperative Visual acuity.
Materials and Methods: This clinical study was undertaken in 100 Eyes- 50 ECCE; 50 SICS consisting of 57 Males and 43 Females aged between 40 - 80yrs who were admitted and operated for Cataract at Saveetha Medical college Hospital, Thandalam. After Securing the inform consent, total number of 100 patients were enrolled for the study. Study was statistically analysed by Chi-squared Test. The filtration angle of each Eye was examined with a Goldmann two mirror Gonio Lens Pre Operative and Post Operatively in a prospective manner. Post Operative Gonioscopic examination was performed between 6 weeks and 3rd Post Operative month to observe any changes.
Results: Posterior chamber IOL implantation was undertaken in total 100eyes among which 57 Males and 43 Females majority aged between 50 – 60 years. 50patients underwent ECCE with PC IOL implantation. 50 patients underwent Small Incision Cataract Surgery with PCIOL Implantation. PAS formation was observed in 28 eyes of 50 cases, which underwent conventional ECCE with PC IOL implantation. No PAS was seen in eyes that underwent SICS, Superior angle PAS noted in 23 eyes. Inferior angle PAS in 5 eyes. 20 eyes showed PAS overlying the Haptics of PC IOL. Which accounts to 71.4%. Most of the lens Haptics PAS were observed early in the Post operative period (3 Months) and remain stable in size. The Scheie’s method of grading TM pigmentation was followed. Large numbers represent increasing amount of pigmentation.
Conclusion: Conventional Extra Capsular Cataract Extraction with PC IOL implantation significantly and permanently alters the Gonio Anatomy of the Eye when compared to Small Incision Cataract Surgery. (P < 0.001). Decrease in the incision size, anterior entry into the cornea with a self-sealing Scleral tunnel incision and a Corneal lip prevents the formation of PAS. In the Bag fixation of IOL reduces Iris chafing related pigment dispersion into the AC and lowers the incidence of changes in the angle. (P <0.001). Continuous Curvilinear Capsulorhexis (CCC) is important for proper capsular bag fixation of the IOL. (P <0.001).

Keywords:
ECCE-Extra Capsular Cataract Extraction, IOP- Intraocular Pressure, PAS- Peripheral Anterior Synechia, PCIOL - Posterior Chamber Intraocular Lens, SICS- Small Incision Cataract Surgery.

Doi No:-10.18231