Maooz Ahmad, Mir Zaman, Bilal Khan Orakzai, Nuzhat Rahil, Bilal Bashir, Asif Iqbal.
Postoperative Refractive Outcome after Manual Small Incision Cataract Surgery (MSICS).
Ophthalmol Update Jan ;13(1):10-4.

Objective: To determine postoperative refractive outcome after manual small incision cataract surgery among patients with cataract. Materials & Methods: It was a descriptive cross sectional study done in Khyber Istitute of Ophthalmic Medical Sciences (KIOMS), Hayatabad Medical Complex (HMC), Peshawar from September, 2011 till April 2012 on 185 patients. All enrolled patients in our study were through Out Patient Department. After informed consent detailed history was recorded on predesigned proforma. Axial length was measured in millimeters with Optikon Hiscan AB-scan through contact A-scan biometry and corneal power measured in diopters (D) with Topcon OM-4 Ophthalmometer. Intraocular lens (IOL) power and target postoperative refraction aimed for emmetropia were calculated using SRK II formula while the ?A? constant used was that provided by IOL manufacturer. All the patients were operated by a single surgeon using standard manual small incision cataract surgery (MSICS) technique and implanting same type of IOL in all patients. All the patients were followed at 2 weeks postoperatively and subjective refraction was done. Spherical Equivalent (SE) refractive error was determined and recorded on predesigned proforma. Data was analyzed using SPSS version 17. Results: One hundred and eighty five eyes of 185 patients above 40 years of age with age related cataract were included in this study. Sixty nine (37.3%) patients presented in the age group of 51-60 years and ninety nine (56.5%) patients entering the study were male. Spherical equivalent postoperative refractive error was within ± 1.00D of the predicted refraction, which in this study was emmetropia, in 146 (78.9%) of eyes and beyond ± 1.00D in 39 (21.1%) eyes. Out of these 39 eyes 27 (14.6%) eyes had hypermetropic (> +1.00D) and 12 (6.5%) eyes had myopic (< - 1.00D) postoperative refractive error. Conclusion: Postoperative refractive outcome in this study is acceptable and is comparable to other international studies. However the results can be improved further with the use of more advanced equipment, newer IOL formulas and personalization of surgeon?s ?A? constant for determining the predicted postoperative refraction.

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