A clinical study of corneal complications of manual small incision cataract surgery

Aims and objectives: To study: (i) the various postoperative corneal complications of manual small incision cataract surgery,(ii) the preoperative and intraoperative risk factors contributing to such complications, and (iii) the final visual outcome in the patients with corneal complications. Design: It is a prospective, hospital based observational study. Materials and methods: We studied 60 eyes of 60 consecutive patients with visually significant cataract who underwent manual small incision cataract surgery with implantation of posterior chamber intraocular lens. The postoperative corneal complications and best corrected visual acuity of these patients were studied on postoperative day 1, 7, 15, 30 and 45. The preoperative risk factors if any and intraoperative complications were noted. Results: 60 eyes of 60 consecutive patients who underwent manual small incision cataract surgery were studied. Corneal complications were seen in 7 patients(11.67%); of these striate keratopathy was seen in 5 patients (8.3%), 1 patient (1.67%) had a Descemet’s membrane detachment and 1 patient (1.67%) had microcystic corneal edema. Corneal complications were seen in patients with preoperative risk factors and in patients with intraoperative difficulties during surgery. At the end of 6 weeks postop, 95% of the patients achieved a best corrected visual acuity of 6/9 or better. Conclusions: Corneal complications after Manual small incision cataract surgery should be anticipated in patients with preoperative risk factors and prolonged and difficult surgeries. With timely and appropriate treatment, most of the corneal complications resolve by the 2nd postoperative week. Careful preoperative planning and meticulous surgery can prevent most of these complications. Keywords: Descemet’s membrane detachment, Manual small incision cataract surgery, Microcystic corneal edema, Striate keratopathy