A Prospective Study on Visual Outcomes of Cataract Surgery after Phacoemulsification with Foldable vs Non Foldable Intraocular Lenses
Shavina Garg1, Harsimran Singh1, Rajinder Khalsa1, Usha Aggarwal2, Anand Aggarwal1*, Indu Khosa1, Kamlinder Kaur1 and Shubham Mittal1
1Department of Ophthalmology, Government Medical College, Patiala, Punjab, India
2Director, Harnam Satsangi Clinic, Civil Lines, Ludhiana, Punjab, India
*Corresponding Author: Anand Aggarwal, Department of Ophthalmology, Government Medical College, Patiala, Punjab, India..
February 10, 2022; Published: February 24, 2022
Purpose: To compare the visual outcomes of cataract surgery with foldable vs non foldable Intraocular lenses after phacoemulsification, at a tertiary Eye centre in Department of Ophthalmology, Government Medical College, Patiala.
Methods: In a prospective, comparative, randomized clinical trial of phacoemulsification cataract surgery, 200 patients received hydrophilic foldable intraocular lenses through 2.8mm clear corneal incision and 100 patients received non foldable Polymethyl Methacrylate (PMMA) intraocular lenses through 5.25mm clear corneal incision. Preoperative and postoperative visual acuity, Pentacam based analysis of astigmatism, dry eye changes and IOP measurements at day 7, 1 month, 3 month and 6 month follow up visits were analysed.
Results: A total of 300 people were enrolled in the trial, 200 were randomly allocated to receive a hydrophilic foldable lens and 100 to receive a non foldable PMMA lens. At 6 months after surgery, 194 out of 200 patients (97%) had best corrected visual acuity of 6/9 or better in foldable group (group I) and 95 out of 100 (95%) in the non foldable group (Group II). Visual acuity of 6/12 - 6/18 was observed in 3% of foldable and 5% of non foldable group (p value - 0.385). None of the cases in both group I and II had best corrected visual acuity worse than 6/18 at the end of 1 month. Vision stabilized in both groups after first month postoperatively. Surgically induced astigmatism was 0.47 0.39 D in group I and 1.03 0.48 D in group 2 at the end of 6 months as compared to baseline. The difference in SIA between both groups was statistically significant (p value < 0.001). Dry eye changes were more in group 2 as compared to group 1 but the difference was not significant. As far as IOP changes were concerned, both the groups didn’t have any significant difference, though the decrease in IOP was significant in each group after 6 months of cataract surgery (p value < 0.05).
Conclusion: Phacoemulsification with implantation of a foldable IOL through a 2.8mm incision leads to less post operative astigmatism as compared to phacoemulsification with implantation of a non foldable IOL through 5.25mm incision. The main concern of patients is final visual outcome, which remains the same with both foldable and non foldable IOLs. Therefore, phacoemulsification with either implantation of a foldable or an inexpensive rigid PMMA IOL gives excellent results in hands of experienced cataract surgeons.
Keywords: Cataract; Phacoemulsification; Intraocular lenses; Visual Acuity; Surgically Induced Astigmatism; Intraocular pressure
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