Manual small incision cataract surgery – eyewiki gas city indiana weather


In order to make this technique sustainable in the developing world, additional innovations included the local manufacture of high-quality posterior chamber intraocular lenses for US$7 each, the development of a low-cost operating microscope (US$3000) and the development of a low-cost yttrium aluminium electricity explained garnet laser (US$1200). The authors reported that average operative time was under 10 minutes and the average cost was less than $20 per surgery. [3] Modifications

In their first report on MSICS outcomes, Ruit and colleagues analyzed data from 62 consecutive cases performed at Tilganga Eye Centre in Kathmandu, Nepal and 207 cases from a remote eye camp in rural Nepal. [2] The authors reported that 87.1% of patients from Tilganga had best-corrected visual acuity (BCVA) of 20/60 or better. Approximately 50% of patients at the rural eye camp had a preoperative visual acuity of counting fingers at 2 feet or worse and 74.1% had BCVA 20/60 or better at two months postoperatively. As familiarity with the MSICS technique has improved so have outcomes. In a 2007 report from the Tilganga Eye Centre, 85% of patients undergoing MSICS had an uncorrected visual acuity (UCVA) of 20/60 or better circle k gas station locations and 98% had BCVA of at least 20/60. [5]

This study and others [7] [6] [8] [10] have compared outcomes between MSICS and phacoemulsification. In the 2007 prospective randomized trial from Tilganga Eye Centre, UCVA, BCVA and keratometric astigmatism were not significantly different between the two surgical groups. However, operative time was significantly shorter for the MSICS cohort (9.0 vs. 15.5 minutes; p.001). Additionally, the per-case cost of surgical supplies was US$70 for phacoemulsification and US$15 for MSICS. [5] In another trial, investigators from electricity distribution companies India also compared phacoemulsification and MSICS. Among both groups, 98% of patients attained a BCVA of 20/60 by post-operative week six. However, UCVA was better in the phacoemulsification group. [7] L. V. Prada Eye Institute, also in India, examined outcomes of MSICS and phacoemulsification performed by ophthalmology trainees at their institution. There was no difference in BCVA between groups. However, the complication rate was higher among the MSICS cohort which was significantly older and had worse preoperative visual acuity. [6] A 2012 study of 127644 cataract surgeries at Aravind Eye Hospital compared complication rates and types of complication for phacoemulsification, MSICS and ECCE. The complication rates for these procedures were 1.01% and 1.11% and 2.6%, respectively. Subgroup analysis showed that the combined complication rate for all trainees was higher with phacoemulsification compared to MSICS. The rate of endophthalmitis did not differ by surgical method. [10] A recent Cochrane Review sought to synthesize available data comparing grade 9 electricity unit review phacoemulsification and MSICS. Eight trials with a total of 1708 patients were included in the meta-analysis. The investigators found similar BVCA using either surgical technique but better short-term UCVA after phacoemulsification. They note that the number of complications was low with both techniques but that they were underpowered to detect differences in complication rate, poor visual outcome or long-term outcome. Overall, in the included studies phacoemulsification was about four times costlier than MSICS. [8] Developing World Applications

Approximately 39 million people are blind electricity distribution network worldwide. [11] According to a 2004 World Health Organization report, 47.8% of blindness worldwide is due to cataract. [12] Of the disability-adjusted life years due to cataract more than 90% are in the developing world. [13] Cost of surgery and lack of awareness are the most commonly cited barriers to patients obtaining surgery in developing countries (Tabin 2005 c gastronomie). Accordingly, solutions are needed to provide high-volume, low-cost cataract surgery. Investigations have consistently demonstrated similar visual outcomes and complication rates between phacoemulsification and MSICS, while MSICS is considerably faster, less expensive and less dependent on expensive technology than phacoemulsification. [14] Additionally, some authors have even suggested that MSICS (or ECCE) may be preferred over phacoemulsification for very hard cataracts, which are frequently encountered in resource-poor settings. [15] [14]