RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

ANNEXURE-II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / Name of the Candidate and
Address(In Block Letters) / Dr. MUTHUKUMARAN R.S
S/O M.R.R.SETHURAMAN
#295, 3rd SOUTH CROSS STREET
MARIAPPA NAGAR, ANNAMALAI NAGAR
POST, CHIDAMBARAM
TAMIL NADU 608-002
2. / Name of the institution / MVJ MEDICAL COLLEGE AND RESEARCH HOSPITAL, HOSKOTE
BANGALORE 562-114
3. / Course of study and Subject / M.S.( OPHTHALMOLOGY)
4. / Date of admission to the course / 18-06-2013
5 / Title of the topic / A COMPARATIVE STUDY OF POST-OPERATIVE ASTIGMATISM INDUCED BY PHACOEMULSIFICATION AND MANUAL SMALL INCISION CATARACT SURGERY AT MVJMC&RH

6.BRIEF SUMMARY OF THE INTENDED WORK:

6.1 NEED FOR THE STUDY:

Astigmatism is one of the causes of reduced vision post operatively. Control of surgically

induced astigmatism has become a clinical efficacy benchmark when evaluating cataract

surgical outcomes. This study is done to find the effective method of cataract surgery

(Phacoemulsification or Manual Small Incision Cataract Surgery)which induces the

least or no astigmatism post surgically.

6.2 REVIEW OF LITERATURE:

In a randomized control trial study (Dec. 2001) by Dr. Minassian, et al he concluded that Phacoemulsification is clinically superior to Extracapsular Cataract Surgery and cost effective[1] `

In a study by Dr. Parikshit Gogate, H V Desai eye hospital , Pune (Nov 2003)studied that Manual SICS and ECCE are both safe and effective techniques for treatment for cataract but manual SICS gives better uncorrected vision[2]

A randomized control clinical trial by Dr.Gogate, et al concludes that both Phacoemulsification and SICS are safe and effective although Phacoemulsification gives better uncorrected visual acuity in a larger proportion of patients at 6weeks[3]

In a prospective randomized clinical trial (Jan 2007) by Dr.Sanduk Ruit, et al cocludes both Phacoemulsification and SICS gives better visual outcome but SICS may be significantly faster, less expensive and more appropriate surgical procedure for treatment of advanced cataracts in developing world[4]

In a comparative study by Dr.Javed Iqbal, et al he says surgically induced astigmatism is more common in Phacoemulsification when suture is applied for wound closure [5]

A study by Dr.Malik, et al showed that Small Incision Cataract Surgery with temporal approach provides better stabilization of refraction with a significantly less surgically induced astigmatism than superior approach[6]

A study by Dr.Yongqi, et al showed that clear temporal corneal incision Phacoemulsification will not increase more keratometric corneal astigmatism than superior scleral incision after three months of operation[7]

6.3. OBJECTIVE OF THE STUDY:

To study and compare the amount of post operative astigmatism induced by

Phacoemulsification and Manual Small Incision Cataract Surgery.

7. MATERIALS AND METHODS:

7.1 SOURCE OF DATA:

Post operative patients who have undergone Phacoemulsification and Manual Small

Incision Cataract Surgery in MVJ Medical College & Research Hospital in ophthalmology department.

7.2  METHODS OF COLLECTION` OF DATA:

1.Method of study: Prospective study

2.Duration of study: November 2013 to October 2015

SAMPLE SIZE: 200 cases will be taken up during 2 year course of time.

Small incision cataract surgery-100 cases

Phacoemulsification-100 cases

Total-200 cases

7.3  INCLUSION CRITERIA:

Post operative patients who underwent Phacoemulsification or Manual Small Incision Cataract Surgery at MVJ Medical College & Research Hospital ,Hoskote

7.4  EXCLUSION CRITERIA:

1.Pre existing corneal disease

2.Patients with any previous ocular surgeries like trabeculectomy, pterygium excision.

Methodology:

Patients who have undergone either Phacoemulsification or Manual Small Incision Cataract Surgery are studied under slit lamp for anterior segment, posterior segment examination by fundoscopy , refraction by retinoscopy done whose readings are confirmed by keratometry on post operative day two,

The patients are asked to review after one week, three weeks and six weeks and at every visit they are subjected to – slit lamp examination for anterior segment, fundoscopy to examine posterior segment, refraction by retinoscopy and auto-refractometer, the readings are confirmed by keratometry.

The changes in astigmatism induced by Phacoemulsification and Manual Small Incision Cataract Surgery are recorded from time to time.

Final results at the end of sixweeks are taken and compared.

7.5 STATISTICAL ANALYSIS:

Descriptive statistical methods like proportion, frequency, mean, median, standard deviation will be used. Statistical Z test is used to compare the changes in astigmatism by the two surgical methods.Data will be entered in Microsoft excel.

7.6 Does the study require any investigation or intervention to be conducted on patients or other humans or animals? If so, please describe briefly:

No

7.7 Has the ethical clearance been obtained from your institution in case of 7.6?

Yes

8.LIST OF REFERENCES:

1.Minassain DC, Rosen P, Dart JK, Reidy A, Desai P, Sidhu M, et al Extracapsular Cataract Extraction compared with Small Incision surgery by Phacoemulsification: a randomized trial. Br J Ophthalmol 2001;85:822-829

2. Gogate PM, Deshpande M, Wormald RP, Deshpande R, Kulkarni SR, Extracapsular Cataract Surgery compared with manual Small Incision Cataract Surgery in community eye care setting in western India: a randomized trial. Br J Ophthalmol 2003;87:667-672

3. Gogate PM, Kulkarni SR, Krishnaiah S, Deshpande RD, Joshi SA, Palimkar A, et al. safety and efficacy of Phacoemulsification compared with manual Small Incision Cataract Surgery by a randomized controlled clinical trial: six week results. Ophthalmology 2005;112:869–874

4. Sanduk Ruit, Geoffrey Tabin, David chang, Leena Bajracharya, Daniel C Kline, William Richheimer, et al prospective randomized clinical trial of Phacoemulsification versus manual sutureless Small Incision extracapsular Cataract Surgery in Nepal. Am J ophthalmol 2007;143:32-38

5.CH Javed Iqbal, Rizwan Gul, Muhammad Sohail Arshad, Mumtaz Hussain. Comparative study of post operative astigmatism following Phacoemulsification with suture versus unsutured wound. Pak J ophthalmol 2011;5;243-247.

6.V H Malik, S Kumar, R Kanboj, C Jain, K Jain, S Kumar. Comparision of astigmatism following manual SICS- Superior versus Temporal approach Nep J Ophthalmol 2012;4:54-58

7.Yongqi He, Siquan Zhu, Ming Chen, Dejiao Li. Clinical study: Comparision of Keratometric corneal astigmatism power after Phacoemulsification: Clear temporal corneal incision versus superior scleral tunnel incison J Ophthalmol2009;210621.

9. Signature of the candidate:

10. Remarks of the Guide :The study will give an opportunity to assess the post operative astigmatism and to improve vision to a great extent.

11.1 Name and Designation of the Guide: Dr.S.PANDU

Professor and HOD,

Department of Ophthalmology

MVJ Medical college& research hospital.

Hoskote, Bangalore.

11.2. Signature :

11.3. Co-Guide (If Any) :

11.4 Remarks of the Co-Guide:

11.4. Signature :

11.5. Head of the Department :Dr.S.PANDU

Professor and HOD,

Department of Ophthalmology

MVJ Medical college& research hospital.

Hoskote, Bangalore.

11.6. Signature :

12.1. Remarks of the Chairman and Principal:

12.2. Signature :