Safety and efficacy of manual small incision cataract surgery for phacolytic glaucoma

• Published in: British journal of ophthalmology 2007-03, Vol.91 (3), p.279-281
• Main Authors: Venkatesh, Rengaraj, Tan, Colin S H, Kumar, Thangavel Thirumalai, Ravindran, Ravilla D
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Astigmatism; Biological and medical sciences; Cataract - complications; Cataract Extraction - adverse effects; Cataract Extraction - methods; Cataracts; CCC; Confidence intervals; continuous curvilinear capsulorrhexis; Developing countries; Diabetes; Diabetic retinopathy; ECCE; Edema; extracapsular cataract extraction; Eye surgery; Female; Glaucoma; Glaucoma and intraocular pressure; Glaucoma, Open-Angle - etiology; Glaucoma, Open-Angle - physiopathology; Glaucoma, Open-Angle - surgery; Hospitals; Humans; Hypertension; intraocular lens; Intraocular Pressure; IOL; IOP; LDCs; Lens diseases; Male; manual small incision cataract surgery; Medical sciences; Middle Aged; Miscellaneous; MSICS; OCTET; Ophthalmology; Oxford Cataract Treatment and Evaluation Team; PMMA; Polymethyl methacrylate; Surgery; Surgical techniques; Treatment Outcome; Viscoelasticity; Visual Acuity; World View
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2006.105874

Aims: To evaluate the safety, visual outcome and complications of manual small incision cataract surgery (MSICS) in the treatment of patients with phacolytic glaucoma. Methods: In a nonrandomised interventional case series, 33 consecutive patients with phacolytic glaucoma underwent cataract extraction by MSICS, with staining of the anterior capsule by trypan blue. Results: The mean preoperative intraocular pressure (IOP) was 46.2 mmHg. No significant intraoperative complications such as posterior capsule rupture or expulsive hemorrhage occurred. In 31 patients (93.9%), an intraocular lens (IOL) was implanted in the posterior chamber. In two of 33 patients (6.1%), the posterior capsule was removed and the patient was left aphakic because of severe pre-existing zonulysis. The postoperative best-corrected visual acuity was 20/60 or better in 29 cases (87.9%) and 20/40 or better in 26 patients (78.8%). The IOP was 22 mmHg or less in all 33 cases without the use of anti-glaucoma medications and the mean IOP was 15.1 mmHg (range, 7–22, SD ± 3.9). Postoperative corneal edema occurred in 11 cases (33.3%) and anterior chamber inflammation was present in nine cases (27.3%). Both conditions resolved with standard medical therapy. Conclusion: Manual small incision cataract surgery with trypan blue staining of the anterior capsule is a safe and effective method of cataract extraction for patients with phacolytic glaucoma.