The first group underwent intracapsular cataract extraction, while the second group underwent extracapsular cataract extraction. There are 3 main indications: aphakia after intracapsular cataract extraction, traumatic cataract, and intraoperative complications during planned extracapsular surgery. Removing cataract by phacoemulsification may result in a better visual acuity compared to ECCE, with a lower complication rate. A 10-year follow-up study. Much like intracapsular fractures, these are most commonly a fracture of elderly, osteoporotic bone; As an entity (both intertrochanteric and subtrochanteric) extracapsular neck of femur fractures are almost twice as common as intracapsular fractures Risk factors for extracapsular neck of femur fractures. Two authors independently selected and assessed all studies. You can download the paper by clicking the button above. In most surgeries, an intraocular lensis inserted. DOI: 10.1002/14651858.CD008812.pub2, Copyright © 2021 The Cochrane Collaboration. These trials included participants with age-related cataract and were conducted in Europe, South America and the Far East. Thirty patients of both sexes and of different age groups were admitted to Alexandria University Hospital, Ophthalmology Department, for cataract extraction. We last searched the electronic databases on 13 May 2013. The procedure has a relatively high rate of complications due to the large incision required and pressure placed on the … The studies were generally at unclear risk of bias due to poorly reported trial methods and the overall quality of the evidence for different outcomes ranged from moderate to very low. A third study reported similar costs for phacoemulsification and ECCE up to six weeks postoperatively, but following this time point ECCE incurred additional costs due to additional visits, spectacles and laser treatment to achieve a similar outcome. Intracapsular cataract extraction (ICCE) involves the removal of the lens and the surrounding lens capsule in one piece. This paper discusses the basic methodologies, advances in microsurgical technique, and major trends involving four methods of cataract extraction: planned extracapsular cataract extraction, phacoemulsification, pars plana lensectomy, and intracapsular cataract extraction. In all cases there was a direct contact between the posterior capsule and silicone bubble. Age below 70 years was not statistically significantly correlated to retinal detachment. Foldable lenses are generally used for the 2-3mm phaco incision, while non-foldable lenses are placed through the larger extracapsular incision. The only method of treatment for this condition is surgery to remove the opacified lens and to replace it with a new lens, usually made of plastic. Phacoemulsification surgical costs were higher than ECCE in two studies. Art. Simultaneous Bilateral Cataract Extraction: ECCE versus ICCE PER JULIUS NIELSEN Eye Department, Hjorring Hospital, DK-9800 Hjorring, Denmark OBJECTIVE: To evaluate the differences in visual rehabilitation between intracapsular (ICCE) and extracapsular (ECCE) cataract surgery as well as the significance for visual performance of the position of an intraocular lens in the eye. Comparing two different techniques of removing cataracts, Comparison of two different methods of lens removal in cataract surgery, particularly relevant to lower income settings, Different-sized incisions for cataract surgery in people with age-related cataract, Surgery to remove cataracts after vitrectomy, Accommodative intraocular lenses compared with monofocal intraocular lenses in cataract surgery. Usually, the tunnel is self-sealing and does not need sutures. Intracapsular Cataract Surgery. We reviewed … Studies that have emerged in the last several years allow us to compare surgical results between different techniques and suggest that there is little difference in final outcome when each surgery is done well. RD, particularly because the abandonment of intracapsular cataract extraction in favor of extracapsular cataract extraction during the late 1970s resulted in a significant decline in the incidence of pseudophakic RD [6,7,12,21,22]. Complications were higher in the ECCE group than the phacoemulsification group. The difference was not statistically significant. Bourne WM, Waller RR, Liesegang TJ, Brubaker RF. In summary, on the basis of the few studies that reported outcomes that we could include in our analysis, visual outcomes were better with phacoemulsification and complications were lower with this technique. This procedure requires an even bigger wound than ECCE and involves removing both the lens and the capsule that holds the lens. This is posted for educational purpose. Comparativestudy of retinal detachment in relation to intracapsular and extracapsular cataract extraction Radi Huda, K.; AI Hadithi, Fakhri, M. +Affiliation. III.B. The lower cost of ECCE may justify its use in a patient population where high-volume surgery is a priority, however, there are a lack of data comparing phacoemulsification and ECCE in lower-income settings. This procedure requires a much smaller incision than the older process called Intracapsular Cataract Extraction in which the lens and the entire capsule were removed. We evaluated these for any biases that may have affected the data, extracted data according to pre-determined criteria and performed analyses of the pooled data from all studies where possible. Thus, people who undergo intracapsular cataract surgery have long recovery periods and have to wear very thick glasses. Two main types of surgical procedures are in common use throughout the world. Extracapsular Cataract Extraction. Cataract developed faster in the nondiabetic group and in the eyes with partially detached retinas. As the quality of cataract surgery varies mainly because of the difference between intracapsular and extracapsular cataract extraction, we identified ophthalmic units where both techniques wereperformed routinely and surveyed 593 general practitioners within the catchment areas of these units. Iraqi commission for Medical Specialization Baghdad ; , Iraqi Postgrad. Follow‐up time was 2 1/2 ‐ 4 1/2 years in both series. In 1984, our ophthalmology department switched from intracapsular cataract extraction (ICCE) to extracapsular cataract extraction (ECCE). PMID: 7709481 Intracapsular and extracapsular cataract extractions had been performed, and different types of lenses had been implanted. The patients were subdivided into . You can help make health evidence easier to understand! We included randomised controlled trials of phacoemulsification compared to ECCE for age-related cataract. To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to upgrade your browser. Cataract surgery has undergone enormous change in the last 20 years. No study reported presenting visual acuity, so we report both uncorrected (UCVA) and best corrected visual acuity (BCVA). The first procedure is phacoemulsification (phaco) and the second involves two different types of extracapsular cataract extraction (ECCE). significant difference between the mean endothelial cell loss of 17.0% in 24 poste-rior chamber lenses and 12.1% in 69 transiridectomy clip lenses, both with extracapsular cataract extraction. No. Removal of the capsule requires a large incision and doesn't allow comfortable intraocular lens implantation. When combined with intraocular lens implantation, extracapsular cataract extraction, even when performed by surgeons inexperienced with extracapsular … We did not use any date or language restrictions in the electronic searches for trials. We examined the central corneal endothelium before and eight weeks after cataract extraction and lens implantation in 99 consecutive intracapsular and extracapsular extractions each. two groups each of 15. Also known as intracapsular cataract extraction (ICCE) is the least common surgical technique these days unless in cases of significant trauma. Whereas extracapsular cataract extraction is the only technique practicable in young patients and in many patients with traumatic cataract, there is a choice between intracapsular and extracapsular extraction in patients with senile cataracts. de Silva SR, Riaz Y, Evans JR. Phacoemulsification with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract. AIMS/BACKGROUND Phacoemulsification is rapidly replacing conventional extracapsular cataract extraction (ECCE) as the method of choice for cataract surgery in the Western world. People in the phacoemulsification group were also more likely to achieve BCVA of 6/12 or more at three months (RR 1.12, 95% CI 1.03 to 1.22, four studies, 645 participants) and one year (RR 1.06, 95% CI 0.99 to 1.14, one study, 439 participants), but the difference between the two groups was smaller. The lens is then replaced with an artificial plastic lens (an intraocular lens implant) of appropriate power which remains permanently in the eye. Extracapsular cataract extraction (ECCE) was done in 75 eyes. Academia.edu no longer supports Internet Explorer. Med. The aim of this review is to examine the effects of two types of cataract surgery for age-related cataract: phacoemulsification and extracapsular cataract extraction (ECCE). There was no statistically significant difference between the mean endothelial cell loss of 17.0% in 24 posterior chamber lenses and 12.1% in 69 transiridectomy clip lenses, both with extracapsular cataract extraction. During an intracapsular cataract extraction (ICCE), the entire natural lens and capsule that holds it in place are removed. After extracapsular lens extraction the majority of cases (60%) were caused byS. The difference was not statistically significant. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2013), EMBASE (January 1980 to May 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to May 2013), Web of Science Conference Proceedings Citation Index - Science (CPCI-S) (January 1970 to May 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). Recent findings Surgical techniques for manual extracapsular cataract extraction have undergone much refinement, with numerous descriptions of techniques in a recent literature. Follow-up time was 2 1/2-4 1/2 years in both series. Age-related cataract is one of the leading causes of blindness worldwide. Extracapsular cataract extraction (ECCE) is a category of eye surgery in which the lens of the eye is removed while the elastic capsule that covers the lens is left partially intact to allow implantation of an intraocular lens (IOL). Cataract is a clouding of the lens in the eye and is one of the leading causes of blindness worldwide. Coventional extracapsular cataract extraction makes a 12-mm incision at the superior limbus that is closed with sutures. We also collected data on intra and postoperative complications, and the cost of the procedures. Between January 1966 and January 1976 a series of 500 eyes with senile cataract was treated by the author with planned extracapsular extraction and primary lens implantation, 354 patients in … Code 66983 Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) includes ICCE and the insertion of the lens prosthesis. A search was performed of the literature in May 2013 for studies comparing the two techniques and 11 randomised controlled trials were identified which included a total of 1228 participants. And since intracapsular cataract extraction (ICCE) can be accomplished using 4.Ox magnifying loupes, the latter has been presented as an advantage of this … In contrast, SICS removes the nucleus through a 6-mm scleral tunnel and aspirates the remaining cortex. : CD008812. surgery has evolved from intracapsular cataract extraction (ICCE) to extracapsular cataract extraction (ECCE) and today to phacoemulsification (Phaco) that uses modern technology. springer Bleeding was associated with the following surgical procedures: perforating keratoplasty (5 ×), extracapsular cataract extraction (3 ×), pars plana vitrectomy (2 ×), intracapsular cataract extraction (1 ×). We included 11 trials in this review with a total of 1228 participants, ranging from age 45 to 94. In 59 eyes intracapsular cataract extraction (ICCE) was performed and in 7 eyes pars plana lensectomy (PPL). difference between intra- and extracapsular surgery in * P< 0.0001 compared to ICCE. Corneal trauma in intracapsular and extracapsular cataract extraction with lens implantation. J. There were few studies that reported outcomes which met our pre-defined criteria. Cochrane Database of Systematic Reviews 2014, Issue 1. Extracapsular cataract extraction in a mature cataract with rigid IOL implantation. No experience or expertise needed, just 30 minutes to volunteer for a study where you will read 2 summaries and answer questions. There are various surgical techniques for removing the lens, and in this review we compare two of them: phacoemulsification and extracapsular cataract extraction (ECCE). Studies varied in visual acuity assessment methods and time frames at which outcomes were reported. This approach is contrasted with intracapsular cataract extraction (ICCE), an older procedure in which the surgeon removed the complete lens within its capsule and left the eye … epidermidis (statistical significance 0,01). Our health evidence - how can it help you. However, two out of three studies that reported costs indicated that ECCE was cheaper than phacoemulsification. Iris prolapse, cystoid macular oedema and posterior capsular opacification were also higher in the ECCE group than the phacoemulsification group. The difference in functional result is explained by the difference in bacteriology: if only theS. The difference between extracapsular and intracapsular extraction is that when an extracapsular extraction is performed, only the lens material is removed with the posterior capsule remaining intact; whereas for intracapsular extraction, which is rarely performed, the entire capsule as well as the lens material is removed. Phacoemulsification gave superior results at both three and 12-month time points. Anomalous Posterior Vitreous Detachment and Vitreoschisis, A comparative evaluation of outcome of cataract surgery at Ago-Iwoye, Ogun State, Acute and chronic fluid misdirection syndrome: pathophysiology and treatment, Retinal detachment following intracapsular cataract extraction. Extracapsular cataract surgery is the removal of the lens where the capsule is left in place. Age below 70 years was not statistically significantly correlated to retinal detachment. Extracapsular Cataract Extraction is a method of cataract surgery that involves removing the eye’s natural lenses while leaving the back of the capsule that holds the lens in place. Indian ophthalmologists have published a number of papers in recent years comparing SICS to phaco. Extracapsular cataract extraction (ECCE) is a category of eye surgery in which the lens of the eye is removed while the elastic capsule that covers the lens is left partially intact to allow implantation of an intraocular lens (IOL). A search was performed of the literature in May 2013 for studies comparing the two techniques and 11 randomised controlled trials were identified which included a total of 1228 participants. However, posterior capsule opacification (PCO) still remains the major postoperative complication, affecting 20–50% of patients, and results from persistent cell growth of epithelial cells remaining after … Participants in the phacoemulsification group were more likely to achieve UCVA of 6/12 or more at three months (risk ratio (RR) 1.81, 95% confidence interval (CI) 1.36 to 2.41, two studies, 492 participants) and one year (RR 1.99, 95% CI 1.45 to 2.73, one study, 439 participants). The review is currently underpowered to detect differences for rarer outcomes, including poor visual outcome. The small incision size used in phacoemulsification (2-3mm) often allows "sutureless" incision … Preretinal membrane 18 (12.3%) 2 (8.0%) 2 (6.7%) ICCE = intracapsular cataract extraction: ECCE-D = extracapsular cat- aract extraction with surgical discission; ECCE-CI = extracapsular cataract eye in humans. A total of 367 (62%) completed questionnaires were received. The incidence of retinal detachment was 0.79% after intracapsular cataract extraction and 0.44% after extracapsular cataract extraction. Sorry, preview is currently unavailable. No trials reported BCVA less than 6/60 but three trials reported BCVA worse than 6/9 and 6/18: there were fewer events of this outcome in the phacoemulsification group than the ECCE group at both the three-month (RR 0.33, 95% CI 0.20 to 0.55, three studies, 604 participants) and 12-month time points (RR 0.62, 95% CI 0.36 to 1.05, one study, 439 participants). The studies were generally at unclear risk of bias due to poorly reported trial methods. Therefore, it is important to establish the most effective surgical technique for cataract surgery. In addition, Osterlin 10 found a striking extraction with posterior capsules preserved intact. Enter the email address you signed up with and we'll email you a reset link. We use cookies to improve your experience on our site. epidermidis cases are compared, functional results between both categories are nearly equal. The incidence of retinal detachment was 0.79% after intracapsular cataract extraction and 0.44% after extracapsular cataract extraction. Three trials reported posterior capsule rupture: this occurred more commonly in the ECCE group than the phacoemulsification group but small numbers of events mean the true effect is uncertain (Peto odds ratio (OR) 0.56, 95% CI 0.26 to 1.22, three studies, 688 participants). There are various surgical techniques for removing the lens, and in this review we compare two of them: phacoemulsification and extracapsular cataract extraction (ECCE). We defined two primary outcomes: 'good functional vision' (presenting visual acuity of 6/12 or better) and 'poor visual outcome' (best corrected visual acuity of less than 6/60) at three and 12 months after surgery. However, ECCE was cheaper and in lower income countries ECCE may therefore have a role in maximising the number of people that can be treated with limited resources. During an extracapsular cataract extraction (ECCE), the natural lens is removed, leaving in place the back of the capsule that holds the lens in place…