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

Abstract

To evaluate the safety, visual outcome and complications of manual small incision cataract surgery (MSICS) in the treatment of patients with phacolytic glaucoma. 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. 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. 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.