Incision Phacoemulsification Research Articles

A Comparative Study of Tear Film Dysfunction After Small Incision Cataract Surgery and Phacoemulsification

A Comparative Study of Tear Film Dysfunction After Small Incision Cataract Surgery and Phacoemulsification

Traumatic Rosette cataract: A case report

Rosette cataract is characterized by a star-shaped opacity that forms in the lens of the eye after blunt or penetrating trauma. Traumatic cataracts constitute a significant portion of ocular injuries, with rosette cataract being a distinctive subtype. Understanding its formation and progression is critical for effective management. Blunt trauma to the eye causes a shock wave that disrupts the lens fibres. This disruption leads to the characteristic rosette pattern due to peculiar lens fibres arrangement. Patients may present with blurred vision, glare, and photophobia due to associated traumatic iritis. The rosette pattern may be visible upon slit-lamp examination. In early stages, observation and protective eyewear may be recommended. Significant visual impairment due to rosette cataract will require cataract surgery. Either small incision cataract surgery or Phacoemulsification with intraocular lens (IOL) implantation is the standard treatment for advanced cases. Timing of surgery depends on the degree of visual impairment and patient’s needs.

A comparative lens: Manual small incision cataract surgery versus phacoemulsification

A comparative lens: Manual small incision cataract surgery versus phacoemulsification

REFRACTIVE OUTCOMES COMPARISON IN LIMBAL RELAXING INCISION BASED ON INCISION DEPTH IN MANAGING CORNEAL ASTIGMATISM DURING CATARACT SURGERY

Abstract
 Introduction & Objectives : Introduction: Prevalence of clinically significant astigmatism of more than 1D can be found in 20 to 50% population those undergo cataract surgery. During phacoemulsification surgery, astigmatism could be corrected by toric intraocular lens (IOL) or incisional technique such as limbal relaxing incision (LRI). LRI are safe and inexpensive procedures thus results in satisfying outcomes with surgeon’s precise phacoemulsification incision and accurate LRI arc position, which most appropriate treatment choice for surgeons in rural area that has problematic access towards IOL supply. Objectives: To compare refractive outcomes of LRI technique with incision depth of 500um and 600um using diamond knife corresponding with phacoemulsification cataract removal.
 Methods : Prospective cumulative interventional case study included 30 eyes of consecutive cataract corneal astigmatic patients power >1.0D those undergoing LRI and phacoemulsification. Length, numbers, and arc position of LRI were calculated on LRI Calc application to obtain best results in minimal astigmatism residual. Uncorrected visual acuity, intraocular pressure, and keratometric cylinder were also analysed before surgery, Day-1, Day-7, and 1-Month post-operation.
 Results : Day-1 follow-up keratometry shown that corneal astigmatism was still fluctuated, day-7 follow-up was even better with significant improvement in visual acuity. 1-Month post-operation has reached target correction. Moreover, visual acuity and residual astigmatism was better in 600um incision depth.
 Conclusion : When toric IOLs are not available or contraindicated, LRI could be a good option in correcting astigmatism with better refractive outcomes trend in 600um incision depth. LRI results better be evaluated in day-7 and 1-Month post-LRI, which may due to more stable corneal surface.

REFRACTIVE OUTCOMES COMPARISON IN LIMBAL RELAXING INCISION BASED ON INCISION DEPTH IN MANAGING CORNEAL ASTIGMATISM DURING CATARACT SURGERY

Introduction & ObjectivesIntroduction: Prevalence of clinically significant astigmatism of more than 1D can be found in 20 to 50% population those undergo cataract surgery. During phacoemulsification surgery, astigmatism could be corrected by toric intraocular lens (IOL) or incisional technique such as limbal relaxing incision (LRI). LRI are safe and inexpensive procedures thus results in satisfying outcomes with surgeon’s precise phacoemulsification incision and accurate LRI arc position, which most appropriate treatment choice for surgeons in rural area that has problematic access towards IOL supply. Objectives: To compare refractive outcomes of LRI technique with incision depth of 500um and 600um using diamond knife corresponding with phacoemulsification cataract removal.
 Methods : Prospective cumulative interventional case study included 30 eyes of consecutive cataract corneal astigmatic patients power >1.0D those undergoing LRI and phacoemulsification. Length, numbers, and arc position of LRI were calculated on LRI Calc application to obtain best results in minimal astigmatism residual. Uncorrected visual acuity, intraocular pressure, and keratometric cylinder were also analysed before surgery, Day-1, Day-7, and 1-Month post-operation.
 Results : Day-1 follow-up keratometry shown that corneal astigmatism was still fluctuated, day-7 follow-up was even better with significant improvement in visual acuity. 1-Month post-operation has reached target correction. Moreover, visual acuity and residual astigmatism was better in 600um incision depth.
 Conclusion : When toric IOLs are not available or contraindicated, LRI could be a good option in correcting astigmatism with better refractive outcomes trend in 600um incision depth. LRI results better be evaluated in day-7 and 1-Month post-LRI, which may due to more stable corneal surface.

Assessment And Comparison of Bacterial Contamination in Anterior Chamber Aspirates in Small Incision Cataract Surgery (SICS) And Phaco-Emulsification

Introduction: The rate of occurrence of endophthalmitis after cataract surgery has been reduced to a greater extent now a day. Even then endophthalmitis related consequences are devastating. Several sources of infection, including contamination by air, solutions, surgical instruments, intraocular lens, and wound leakage have been identified. Aim of the Study: The study aimed to evaluate the influence of two methods of surgical technique of cataract surgery in bacterial as well as comparison of contamination by these two techniques. Methods: This prospective observational study was conducted over 60 patients with age related cataract in the department of Ophthalmology and Microbiology in Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, from 1st January, 2009 to 30th June, 2009. Patients were selected purposively based on specific selection criteria. Selected patients underwent detail ophthalmic and systemic evaluation as well as relevant investigations. Cataract extraction followed by intraocular lens implantation was planned for all patients. The two techniques of cataract surgery such as SICS and Phacoemulsification were assigned to the patients randomly by 1:1 basis. 1 ml of anterior chamber contents were aspirated through aseptic technique by 26G needle from each patient pre-operatively, after capsulorrhexis (early per-operative) and just before wound closure by stromal hydration (late per-operative). All samples were sent for 10% KOH staining and culture and sensitivity test after proper leveling. Results: Micro-biological examination shows no sample was positive for 10% KOH staining. In SICS group, out of 30 samples 3 were found culture positive, which were positive in 4 and 5 samples in early per-operative and late per-operative sample respectively and in Phacoemulsification group, it was 2, 3, 5 pre-operative, early per-operative and late per-operative sample respectively. The common organisms isolated were Coagulase positive Streptococcus, Corynebacterium species, Streptococcus viridans, and Staphylococcus aureus etc. Almost none of the patients showed clinical activity except few cells and flare in the anterior chamber in early post-operative period. Conclusion: The microbiological examination shows the incidence of microbial contamination of anterior chamber contents is very low after cataract surgery by both form of technique, and there was no statistically significance difference in incidence between these two techniques. J.Natl.Inst.Ophthalmol.2023;6(1): 37-41

Comparative Evaluation of Astigmatic Changes Induced by Superior and Temporal Corneal Incisions in Sutureless Phacoemulsification Surgery: A Case Series.

Background In cataract surgery, the effect of corneal incision astigmatism has been widely recognized for many years. The incision's size, shape, and location can all impact the patient's postoperative visual outcomes. Currently, phacoemulsification is considered the most preferred surgical technique for cataract extraction. However, there is still some debate about whether temporal incisions, which are smaller and considered nearly astigmatic neutral, result in more astigmatism than other incisions. As a result, it is important to continue studying the refractive changes induced by corneal incisions made at different sites during phacoemulsification surgery. Aim and objective To compare the incidence, extent, and course of postoperative astigmatic changes associated with superior versus temporal clear corneal incisions for sutureless phacoemulsification cataract surgery. Materials and method In this prospective study, 50 patients of the civil hospital in Gujrat with cataracts who underwent sutureless, small incision (2.8 mm) phacoemulsification surgery were included. The preoperative evaluation comprised visual acuity assessment, refraction, keratometry, fundus examination, and intraocular lens (IOL) power calculation. The superior incision was made in 25 patients, and the temporal incision was made in another 25 patients. Patients were examined preoperatively on day 1, at one week (day 7), after one month (day 30), and after two months (day 60). Result Postoperatively, two months (on day 60) postoperatively, in group A (superior approach), the mean surgically induced astigmatism (SIA) was 0.39±0.34 SD diopters, and in group B (temporal approach), it was 0.5±0.42 SD diopters. A significant statistical difference was not seen between these two groups. Conclusion Surgically induced astigmatism was minimal and comparable with both superior and temporal approaches to clear corneal incisions for phacoemulsification surgery.

Dry eye and corneal sensation following cataract surgery

Aim:To evaluate dry eye and corneal sensation changes after small incision cataract surgery and phacoemulsification. Materials and method :A crossectional study with 60 uncomplicated cataract patients between age 40 and 75yrs who had undergone surgery have been taken for the study. Dry eye and corneal sensation changes have been analysed after phacoemulsification and SICS by schirmer’s test and Cochet-Bonnet esthesiometer. The study was conducted over a period of 3 months in the ophthalmology department of saveetha medical college hospital ,Thandalam. Results :The study was conducted over a period of 90 days postoperatively the corneal sensation was found out to be decreased 35% in GroupA(SICS) and 30% in Group B(phaco emulsification) when compared to the cataract eye before cataract surgery. Out of the patients 8% showed dry eye symptoms with reduced value in Schirmer’s test and of which 10% belongs to Group B

Visual Outcomes of Cataract Surgery at the Eye Foundation Community Hospital in Nigeria

Aims: To determine the visual outcome of cataract surgeries postoperatively at first day, one and three months. 
 Study Design: Retrospective, case series study.
 Place and Duration of Study: Eye Foundation Community Hospital, Ilese-Ijebu-Imushin, Ogun state of Nigeria. 3-month duration from June 1st 2019 to August 31st 2019.
 Methodology: All patients 18 years and above operated for cataract surgery without comorbidity were included in the study. Type of surgery done were manual small incision cataract surgery (MSICS) and phacoemulsification. Patient data were entered into excel spread sheet created for the study. From where it was cleaned up and exported in to statistical package for social sciences 20. Visual outcome was assessed on the first day, first month and at third month post operatively. Snellen visual acuity was converted to log MAR. P value = 0.05 is determined as statistically significant. 
 Results: Two hundred and fifty (250) patients or eyes were analysed in this study. Two hundred and twenty patients (88%) had MSICS, 30 (12%) had phacoemulsification. Preoperatively, majority (150, 60%) presented with visual acuity less than 3/60 followed by patients with visual acuity between 6/18 to 6/60 (76, 30.4%). Nineteen patients (7.6%) had visual acuity of 6/18 or better. Mean preoperative log MAR was 1.6 ± 0.8 (equivalent to count finger). 3-month post op, two hundred and fourteen (85.6%) had uncorrected visual acuity of 6/18 or better while 231 patients (92.4%) had best corrected (with pinhole) visual acuity of 6/18 or better. (P=0.004 and 0.038 respectively). 
 Conclusion: There is an appreciable improvement in the visual outcome following cataract surgery.

Bacterial Contamination Evaluation in Anterior Chamber Aspirates: Contrasting Small Incision Cataract Surgery (SICS) and Phacoemulsification

Introduction: The rate of occurrence of endophthalmitis after cataract surgery has been reduced to a greater extent nowadays. Even then endophthalmitis related consequences are devastating. Several sources of infection, including contamination by air, solutions, surgical instruments, intraocular lenses, and wound leakage have been identified. Aim of the Study: The study aimed to evaluate the influence of two methods of surgical technique of cataract surgery in bacterial as well as comparison of contamination by these two techniques. Methods: This prospective observational study was conducted over 60 patients with age-related cataracts in the Department of Ophthalmology and Microbiology in Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, from 1st January 2009 to 30 June 2009. Patients were selected purposively based on specific selection criteria. Selected patients underwent detailed ophthalmic and systemic evaluation as well as relevant investigations. Cataract extraction followed by intraocular lens implantation was planned for all patients. The two techniques of cataract surgery such as SICS and Phacoemulsification were assigned to the patients randomly on a 1:1 basis. 1 ml of anterior chamber contents were aspirated through an aseptic technique by 26G needle from each patient pre- operatively, after capsulorhexis (early per-operative), and just before wound closure by stromal hydration (late per- operative). All samples were sent for 10% KOH staining and culture and sensitivity test after proper leveling. Results: Micro-biological examination shows no sample was positive for 10% KOH staining. In the SICS group, out of 30 samples, 3 were found culture positive, which were positive in 4 and 5 samples in early per-operative and late per-operative samples respectively, and in the Phacoemulsification group, it was 2, 3, 5 pre-operative, early per- operative and late per-operative sample respectively. The common organisms isolated were ......

Changes in central macular thickness before and after cataract surgery evaluated by optical coherence tomography in non-diabetic patient

Background: Optical coherence tomography (OCT) has been useful for objectively observing central macular thickness (CMT) changes inpre-operative and post-operative uneventful cataract surgery. Aims and Objectives: This study was done to compare changes in CMT in small incision cataract surgery (SICS) and phacoemulsification surgery and to illuminate the OCT features of CMT after uneventful cataract surgery. Materials and Methods: A prospective observational study was done at the tertiary eye care center from December 2019 to November 2020, a total of 60 patients underwent SICS and Phacoemulsification cataract surgery, were followed and examined postoperatively at day 1, 1 week, 1 month, and 6 months for whole ocular examination and OCT. Results: Comparison analysis was performed using Friedman’s analysis of variance test.In SICS and Phacoemulsification group, statistical analysis differences between the mean CMT at pre-operative, post-operative 1 week, 1 month, and 6 months were found statistically significant (P > 0.001), subclinical macular edema (increase CMT without affecting visual acuity) was noted at 1 week and 1 month reviews. Conclusion: The changes in CMT after cataract surgery are reversible, since the maximum measured increase in macular thickness at 1 month after surgery then gradually decreased at 6 months follow-up. This increase remained subclinical, and no evidence of clinical cystoid macular edema was seen on OCT.

A Comparative Study of Vision Outcome Between Small Incision Cataract Surgery (SICS) and Phacoemulsification as Well as Comparison of Mydriatic Effects Between Two Drugs in Cataract Surgery Patients

Aims: Knowing the Mydriatic effect of Tropicamide and Cyclopentolate as well as the difference in vision improvement between phacoemulsification and small-incision cataract surgery. Study type and place: A prospective & cross-sectional study. Total number of cases 1446 were collected over a period of 6 month was conducted in Nagapattinam Government medical college. Objectives: To know the prevalence of cataracts on the basis of age and sex, To find the major systemic co-morbidities in cataract patients, To compare the pupil dilation between Tropicamide and Cyclopentolate, To compare the visual acuity after cataract surgery using SICS and phacoemulsification, To find drug utilization in pre- and post-operative cataract surgery Utilizing statistical analysis: The SPSS software package was used to compute and analyze the data. A 0.05 p value was deemed significant. Results: Among 1446 patients, gender distribution showed that 934 (65%) were female and 509 (35%) were male; According to age category, the majority of the patients in our study who have cataracts are between the ages of 60 and 79. The distribution of patients by eye wise was as follows: right eye (845, or 58%); left eye (601, or 42%); There were 624 cases of immature cataract (43%), 475 cases of mature cataract (32.8%), 289 cases of hyper-mature cataract (19.9%), and 58 cases of pseudophakia (4%).Patients undergoing cataract surgery frequently have diabetes and high blood pressure. One of the risk factors for cataract is diabetes (73.5%). SICS is more successful than phacoemulsification in terms of improving visual acuity, and since the pupil dilated larger with duration, it is Cyclopentolate rather than Tropicamide; Conclusions: By comparing visual acuity measured using the Snellen chart, there was a substantial difference in the visual outcome on the first postoperative day. Small-incision cataract surgery is more effective than phacoemulsification. The difference in pupil diameters between Cyclopentolate and Tropicamide demonstrates that the latter is less effective than the former. Keywords: Cyclopentolate, Diabetic mellitus, small incision cataract surgery, immature cataract, and female

Study of comparison of surgically induced astigmatism after small incision cataract surgery and phacoemulsification surgery

To compare surgically induced astigmatism after manual small incision cataract surgery and phacoemulsification surgery. 2) To know the prevalence of pre-existing astigmatism, it’s magnitude and type and patients with cataract. 3) To calculate the average astigmatism induced after manual small incision cataract surgery and also to know the type of astigmatism and change in it in first month of surgery. 4) To calculate the average astigmatism induced after phacoemulsification surgery and also to know the type of astigmatism and change in its first month of surgery. 5) To study changes in astigmatism and its effect on vision after cataract surgery. 6) To compare astigmatism induced by straight and frown incision after operation.The study was carried out in Department of Ophthalmology, P.D.U government Medical College, Rajkot under guidance of operating surgeons and patients operated in the duration of 24 months from September 2020 to October 2022.Informed consent was obtained from all the patients undergoing study. It was a prospective study and all the patients were randomly selected over the above mentioned period that had cataract with normal anterior and posterior segments. To have a more homogeneous study population all the patients underwent a similar Preoperative, Intra operative, Postoperative Surgical protocols. All eyes were operated under peribulbar anaesthesia with 2% lignocaine+bupivacain+hyalronidase. Superior sclero corneal pocket tunnel with external incision of frown configuration in manual SICS and straight incision in phacoemulsification was made. All the cases with 3.2 mm of incision in phacoemulsification and 6.5 mm incision in manual SICS were taken. Surgically induced astigmatism was then calculated by the subtraction method and vector analysis.Average SIA in SICS was 1.32 SD and in Phacoemulsification was 0.60 SD which means that larger incision size increases SIA. SIA was maximum on first post-operative day and it regressed with time as noted on first post-operative month in both the groups. It decreased from 1.66 D on first postoperative day to 1.32 D on first postoperative month in SICS Patients and from 0.63 D to 0.60 D in Phacoemulsification patient.

Swab Pressing vs Stromal Hydration to Prevent Incision Leakage and Transient Collapse of Anterior Chamber in Phacoemulsification

During phacoemulsification, incision leakage and the subsequent anterior chamber collapse often occur after the withdrawal of the handpiece, which cannot be prevented by current sealing techniques. A new technique called swab pressing is proposed here to apply pressure with a cotton swab to seal the incision immediately, but efficacy remains unknown. To determine if swab pressing is noninferior to stromal hydration, the current practice, in sealing incisions in phacoemulsification for age-related cataract. This noninferiority randomized controlled clinical trial was conducted between February 2022 and September 2022 at the Zhongshan Ophthalmic Center, Guangzhou, China. Patients aged 60 to 90 years with age-related cataract were enrolled. Participants were randomly assigned (1:1) to receive swab pressing or stromal hydration. All surgeries were performed by a single experienced surgeon who was unmasked to the assignment. The proportion of closed clear corneal incisions evaluated using intraoperative optical coherence tomography. A total of 126 eyes of 126 participants were randomized into the swab pressing group (63 [50%]) and stromal hydration group (63 [50%]). The mean (SD) age of participants was 69.2 (6.14) years and 70.1 (7.67) years in the pressing and stromal hydration groups, respectively. A total of 39 participants (61.9%) in the pressing group and 35 (55.6%) in the modified group were female. The proportion of closed incisions was 96.8% (61 of 63) in the swab pressing group and 93.7% (59 of 63) in the stromal hydration group. Noninferiority was met, as the lower 95% CI of -5.83 percentage points was greater than the prescribed noninferiority margin of -6.60 percentage points (difference, 3.17 percentage points; 95% CI, -5.83 to 12.18 percentage points). The rate of anterior chamber collapse (pressing: 0 of 63 vs stromal hydration: 35 of 63 [55.6%]; P < .001) was lower in the swab pressing group. There were no differences between the 2 groups in the proportion of closed incisions and central anterior chamber depth at postoperative hour 1 and day 1. In this study, swab pressing was noninferior to stromal hydration in sealing clear corneal incisions in phacoemulsification for age-related cataract. While this trial involved only 1 surgeon who was not masked to the interventions, the results suggest that swab pressing is feasible and further investigations would be warranted to determine if it prevents the intraoperative transient collapse of anterior chamber or affects visual acuity outcomes. ClinicalTrials.gov Identifier: NCT05242653.

Visual outcome following clear corneal incision phacoemulsification with rigid intra-ocular lens and small incision cataract surgery in low socioeconomic group patients: A comparative analysis in a teaching hospital in South India

Background: Cataract is the most common cause of curable blindness worldwide. Aims and Objectives: A comparative analysis of clear corneal phacoemulsification with rigid intra-ocular Lens (IOL) and small incision cataract surgery (SICS) in low socioeconomic group patients in terms of post-operative visual outcome, surgically induced astigmatism (SIA), and intra-and post-operative complications. Materials and Methods: A prospective hospital-based comparative study was conducted for 8 months in 424 eyes of 400 senile cataract patients divided into PHACO and SICS groups. Each group consisted of 212 eyes of 200 patients. Detailed examinations for best corrected visual acuity (BCVA), SIA, and complications were evaluated on the 1st post-operative day, 1st week and 6 weeks postoperatively. Results: BCVA 6\18 or higher was 95.38% in the phacoemulsification group and 94.81% in the SICS group. The study revealed good visual outcome in both SICS and Phaco groups with no significant difference. The mean SIA was more in SICS group (−0.96±0.57) than in phaco group (−0.71±0.47) which was statistically significant. In terms of complications, no significant difference was noted between the groups. Conclusion: The outcome of this study indicated that though SIA is more in SICS group than Phaco group, there is no difference between the groups in terms of visual outcome. The study has proven that SICS has comparable effectiveness as phacoemulsification with rigid IOL, which should be considered in low- and middle-income countries.

Femtosecond laser-assisted cataract surgery: an incision efficacy review

Purpose: This study reviewed the scientific literature on corneal incisions in femtosecond laser-assisted cataract surgeries compared to keratome incisions in conventional phacoemulsification. Conclusion: There are differences in the results of the studies. Automated incisions are more advantageous in the structure of the cut (reproducible tunnel architecture) and healing time of incisions (epithelial and endothelial gap, endothelial misalignment, Descemet membrane detachment and corneal thickening) compared to manual incisions, in addition to astigmatism correction &lt;1.0 diopter with arcuate incisions. The induction of astigmatism and corneal aberrations is similar between the techniques. Incisions with an angle of entry of 110º in the cornea, triplanar shape, and width of &lt;2.65 mm with the femtosecond laser platforms have presented the best results.

Posterior Polar Cataract Management: My Approach

Posterior polar cataracts (PPC) are cataracts lying on the posterior pole of the lens. They are slicked to the posterior capsule, so there are many times more chances of the post capsule ruptures and related sequelae. In this article, I will share my approach regarding the pre-operative considerations and plans, including patient counseling, anesthesia type, capsulorhexis, hydro procedures, intraocular lens types, cataract surgery methods, and the manual small incision cataract surgery, phacoemulsification and femto laser-assisted cataract surgery. This article will also discuss complications arising from posterior capsule ruptures and their management. This is an e-video article so each section is embedded with the video links and QR codes under the subject with the help of the surgical videos.

Analysis of ocular surface and tear film abnormalities post cataract surgery- small incision cataract surgery V/S phacoemulsification

Aim: To evaluate ocular surface and tear film abnormalities post cataract surgery- small incision cataract surgery (SICS) versus phacoemulsification. Material and methods: The present randomised control trial was conducted among 100 patients attending OPD diagnosed with cataract who underwent surgery; age group of more than 40 years were included in the study and randomly divided into 2 groups i.e. Group 1 (who underwent manual SICS) and Group 2 (who underwent Phacoemulsification). Postoperatively, the diagnosis of dry eyes was done by conducting tests viz. Ocular surface disease index questionnaire (OSDI), Schirmer’s test-1, Tear Break up time (TBUT) and impression cytology (IC). Results: Post cataract surgery, mean Schirmer’s value reduced more in group 1 as compared to group 2 at 1 week, 1 month and 3 month with statistically significant difference (p&lt;0.05). Significant deterioration in OSDI was found in both group 1 as well as group 2 after 1 week, 1 month and 3 months of surgery with statistically significant difference (p&lt;0.05). Conclusion: Incidence of dry eye was found to be higher in group that underwent small incision cataract surgery or SICS than phacoemulsification due to tear film instability.

SCLERAL TUNNEL COMPLICATIONS OF SMALL INCISION CATARACT SURGERY

Cataract surgery is one of the most commonly performed surgeries in the world. The various techniques of cataract surgeries are- conventional extracapsular cataract extraction, small incision cataract surgery and phacoemulsification. Although the developing countries have shifted to phacoemulsification, SICS is still a widely 1,2 performed surgery in the developing world. SICS continues to prove useful in the developing countries where cost constraints are a factor in delivery of sight saving cataract 3 surgery. The results of SICS compares favorably with modern 4,5 phacoemulsification surgery. However there are various complications associated with SICS:1. Tunnel related complication (Premature entry and button hole) 2. complication during capsulorhexis- too small rhexis or extension of rhexis margin 3. Posterior capsular rupture 4. Descmet membrane tear 5. Zonular dialysis 6. Nucleus drop. Tunnel construction is a crucial part of SICS. A scleral tunnel; 5.5-7.5mm in length, 1.5 to 2mm behind the limbus, half to two third of scleral thickness, extending 1-2mm in cornea, with side pockets in sclera is self sealing in nature and requires no .6 sutures at the end of surgery Poorly constructed leads to button hole, premature entry into anterior chamber causing iris prolapse or nucleus may get stuck during delivery. In this case series we will discuss three cases who came to the clinic with late presentation of scleral tunnel related complication after SICS.

Visual outcome and postoperative complications after manual small incision cataract surgery versus phacoemulsification

Visual outcome and postoperative complications after manual small incision cataract surgery versus phacoemulsification