Visual outcome of cataract surgery with pupillary sphincterotomy in eyes with coexisting corneal opacity

BMC Medicine

Rasik B Vajpayee¹  Namrata Sharma¹  Rajesh Sinha¹ 

[1] Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science, New Delhi, India

关键词: sphincterotomy;    corneal opacity;    cataract surgery;   

Others  :  1130749
DOI  :  10.1186/1741-7015-2-10

 received in 2003-10-31, accepted in 2004-04-07,  发布年份 2004

【 摘 要 】

Background

To evaluate the visual outcome following cataract surgery with pupillary sphincterotomy in eyes with coexisting corneal opacity.

Methods

Patients with leucomatous corneal opacity with significant cataract were enrolled for the study. The uncorrected visual acuity and best-corrected visual acuity (BCVA) were recorded and the anterior segment was thoroughly evaluated by a slit lamp biomicroscope before the surgery. Only those patients who had some amount of clear peripheral cornea were selected. Posterior segment pathology was ruled out by indirect ophthalmoscopy after pupillary dilatation, if possible, or by B-scan ultrasonography. Conventional extracapsular cataract extraction with pupillary sphincterotomy was performed and an intraocular lens was implanted. Postoperatively, the eyes were evaluated on day 1, and 1 week and 6 weeks following surgery for similar parameters.

Results

Fourteen eyes of 14 patients were included in the study, of which 13 (92.85%) patients were male. The mean age of the patients was 47.85 ± 7.37 years. All the eyes had a dense central leucomatous corneal opacity. Twelve (85.71%) eyes had two or more quadrants of deep vascularisation. Sphincterotomy was performed mostly (71.42%) in the nasal or inferonasal quadrant. The intraocular lens was implanted in 13 (92.85%) eyes, and one (7.1%) eye was left aphakic due to the occurrence of a large posterior capsular tear. Preoperatively, all eyes had BCVA < 6/60. At 6 weeks after surgery, all eyes had BCVA ≥ 6/60 and four (28.57%) eyes had BCVA ≥ 6/18. The mean BCVA preoperatively in these eyes was 0.015 ± 0.009, which changed to 0.249 ± 0.102 at 6 weeks following surgery.

Conclusions

Extracapsular cataract extraction and intraocular lens implantation with pupillary sphincterotomy provides ambulatory and useful vision to patients of cataract with coexisting central leucomatous corneal opacity.

【 授权许可】

   
2004 Sinha et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

【 参考文献 】

• [1]Eye banks in India. Ophthalmology section In 1996 Status of Eye Banks in India. New Delhi: Directorate General of Health Services, Government of India; 1996:1-6.
• [2]Vajpayee RB, Sharma N, Dada T, Pushker N: Optical sector iridectomy in corneal opacities. Cornea 1999, 18:262-264.
• [3]Kanpolat A, Ciftci OU: The use of rigid gas permeable contact lenses in scarred corneas. CLAO J 1995, 21:64-66.
• [4]Boghani S, Cohen EJ, Jones-Marioneaux S: Contact lenses after corneal lacerations. CLAO J 1991, 17:155-158.
• [5]Titiyal JS, Das A, Dada VK, Tandon R, Ray M, Vajpayee RB: Visual performance of rigid gas permeable contact lenses in patients with corneal opacity. CLAO J 2001, 27:163-165.
• [6]Kok JH, Smulders F, van Mil C: Fitting of aspheric high gas permeable rigid contact lenses to scarred corneas. Am J Ophthalmol 1991, 112:191-194.
• [7]Weber SW, Grawford JS, Arndt JH, Parker JS: Visual acuity after iridectomy or aspiration for congenital cataract. Experimental and clinical studies. Can J Ophthalmol 1978, 13:229-236.
• [8]Drews LC, Drews RC: Optical iridectomy. Am J Ophthalmol 1964, 58:789-796.
• [9]Costenbader FD, Albert DG: Conservation in the management of congenital cataract. Arch Ophthalmol 1957, 58:426-430.
• [10]Junemann A, Gusek G, Nuamann GOH: Optical sector iridectomy: an alternative to penetrating keratoplasty in Peter's anomaly. Klin Monatsbl Augenheilkd 1996, 209:117-124.
• [11]Summers CG, Holland EJ: Neodynium: YAG pupilloplasty in pediatric aphakia. J Pediatr Ophthalmol Strabismus 1991, 28:155-156.
• [12]Melles GRJ, de Waard WT, Pameyer JH, Houdijn Beekhuis W: Trypan blue capsule staining to visualize the capsulorhexis in cataract surgery. J Cataract Refract Surg 1999, 25:7-9.
• [13]Bhartiya P, Sharma N, Ray M, Sinha R, Vajpayee RB: Trypan blue assisted phacoemulsification in corneal opacities. Br J Ophthalmol 2002, 86:857-859.
• [14]Vajpayee RB, Boral SK, Dada T, Murthy GV, Pandey RM, Satpathy G: Risk factors for graft infection in India: a case–control study. Br J Ophthalmol 2002, 86:261-265.