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

Abstract

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.