MANUAL SMALL-INCISION CATARACT SURGERY: OUTCOME AND COMPLICATIONS

Cataract is the primary cause of avoidable blindness worldwide, while age-related cataract is the most common andcataract surgery forms the major workload of most ophthalmic units. Manual small incision cataract surgery (MSICS)has become popular in Libya in the last few years. It is significantly faster, less expensive, require less technology andachieves excellent visual outcomes with low complication rates. The aim of the study is to evaluate the safety, complications and outcome of MSICS in the treatment of patients with mature cataract. Data was collected from medicalrecords of 190 eyes of 184 patients with mature cataract that received surgery at Albasar ophthalmology clinic andMisurata central hospital- Misurata-Libya between January 2014 and December 2017. Out of 184 patients 109 werefemales (59.2%) and 75 were males (40.8%). About 74% of the patients were between 51 and 70 years old. Intraoperative difficulties and complications encountered during surgery were improper tunnel construction inform of premature entry in two (1.05%) cases and button holing in one (0.52%) case. Difficulty in nucleus delivery to anteriorchamber 13 (6.8%) cases, pupillary constriction 10 (5.3%) cases, intraoperative hyphema 13 (6.8%) cases, capsulorrhexis extension and posterior capsular tear with vitreous loss 4 (2.1%) cases, iris prolapse 2 (1.05%) cases. Widening of the incision to facilitate nucleus delivery in 19 (10%) cases. The postoperative complications include hyphema 9 (4.7%) cases, transient corneal oedema 42 (22.1%) cases, corneal decompensation one (0.5%) case. Irregularpupil 13 (6.8%) cases, iritis 11 (5.8%) cases and posterior capsule opacification (PCO) 3 (1.6%) cases. The recordedbest corrected visual acuity (BCVA) three months postoperative was good results (visual acuity 6/12 or better), theaverage results (visual acuity between 6/18 and 6/60) and the poor results (visual acuity less than 6/60) were respectively 82.1%, 12.6% and 5.3%. MSICS can be recommended as an efficacious surgical technique with low complications and good visual outcome in treatment of patients with mature cataract.