Complications of manual small-incision cataract surgery

Abstract

The manual small-incision cataract surgery (MSICS) is instrumental in tackling cataract-induced blindness in developing countries, especially with a sizeable proportion being hard brunescent cataracts. MSICS has a unique set of complications related to wound construction, the creation of the capsular opening, and the technique of nuclear delivery. A poorly constructed sclero-corneal tunnel or a small capsulorhexis hampers the nuclear extraction, and the extensive intracameral maneuvers increase the chances of postoperative corneal edema and iritis. Though MSICS has been shown to have universal applicability, producing replicable visual outcomes requires a significant learning curve. This article reviews the relevant published literature on complications of MSICS utilizing the databases of PubMed, Medline, Cochrane, and Google Scholar.

Keywords: Complications; MSICS; intraoperative; postoperative.

Figure 1

(a) Corneal burn in temporal MSICS due to excessive cauterization. (b) Clinical image showing Descemet’s detachment in the inferior two-thirds of the cornea. (c) Repaired iridodialysis in temporal MSICS. (d) Anterior segment OCT showing Descemet’s detachment. (e) Early corneal edema. (f) Peaked pupil due to iris incarceration in the temporal MSICS. (g) Postoperative endophthalmitis. (h) Decentration of the intraocular lens due to inferior zonular dialysis