Clinical Approach to Black Cataract: Report of Three Cases

Senile cataract remains the leading cause of blindness in Morocco, accounting for 54.6% of cases. Black and brown cataracts represent advanced forms that are particularly challenging to manage surgically. Phacoemulsification, although the gold standard, is technically difficult in these cases and associated with higher risk of intra- and postoperative complications. We report three cases of black cataract managed by manual extracapsular cataract extraction (ECCE) with intraocular lens implantation. Despite intraoperative vitreous loss in two cases, postoperative outcomes were favorable with improved visual acuity. These cases highlight the relevance of ECCE and small incision cataract surgery (SICS) as effective alternatives to phacoemulsification in the management of advanced black cataracts, especially in resource-limited settings.