Manual Small Incision Cataract Surgery (MSICS) in Mature Cataract Using Lerprat Technique: Visual Outcome and Complication
Keywords:
Cataract, Surgery, Lerprat technique, MSICSAbstract
Background: Mature cataract remains a problem in developing countries included Thailand. The World health organization (WHO) data shows that 60% of blindness in developing countries is caused by cataract. For surgical management, Lerprat Technique has been developed by using conventional extracapsular cataract extraction (ECCE) equipment (Sinskey hook, Iris spatula, Simcoe cannula) without the need for costly or invent new instruments. It can be used in cataract hardness, mature cataract that is common in developing countries. Moreover, it does not interfere with the upper conjunctivae which is used in glaucoma surgical treatments if needed in the future. “Lerprat technique” is a new technique by integrating the “Ruit technique” with the “Modified Blumenthal technique”.
Objective: To report visual outcome and complication of manual small incision cataract surgery (MSICS) in mature cataract using Lerprat technique.
Methods: This is a retrospective descriptive study, between January to September 2016. Approval to conduct this study was obtained from the Institutional Review Board Royal Thai Army Medical Department No. IRBRTA 437/2559 and Thai Clinical Trials Registry No. TCTR 20171208003. Data were collected on 60 eyes of 60 patients who performed manual small incision cataract surgery (MSICS) in mature cataract using Lerprat technique. The postoperative visual acuity at first day, 1 week, 6 weeks and 3 months was collected. The intraoperative and postoperative complications were evaluated.
Results: All patients had poor preoperative visual acuity (below 20/200) and achieved improved visual acuity after surgery. On the first postoperative day, the best corrected visual acuity (BCVA) were excellent (20/20-20/30) in 30 cases (50%), good (20/40-20/70) in 28 cases (46.7%) and borderline in 2 cases (3.3%) respectively. On the first postoperative week, visual acuity was excellent (20/20-20/30) in 52 cases (86.7%) and good (20/40-20/70) in 8 cases (3.3%). At 6 weeks and 3 months after operation, visual acuity was excellent (20-20-20/30) in 60 cases (100%). Complications were hyphema in 3 cases (5%) and increased intraocular pressure in one case (1.7%).
Conclusion: Manual small incision cataract surgery (MSICS) in mature cataract using Lerprat technique is safe and effective procedure.
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