MSCIS suitable for phacolytic glaucoma patients

Manual small incision cataract surgery (MSCIS) with trypan blue staining of the anterior capsule is a safe and effective method of cataract extraction for patients with phacolytic glaucoma, according to a report published in the March issue of the British Journal of Ophthalmology.

Rengaraj Venkatesh and colleagues from the Aravind Eye Hospital, India and the Eye Institute at Tan Tock Seng Hospital, Singapore, conducted a non-randomized interventional case series of three patients with phacolytic glaucoma undergoing cataract extraction by MSICS, with trypan blue staining of the anterior capsule.

The mean preoperative intraocular pressure (IOP) was 46.2 mmHg. In 31 patients, an intraocular lens (IOL) was implanted in the posterior chamber and in the further two subjects, the posterior capsule was removed leaving aphakia due to severe pre-existing zonulysis. Postoperative best corrected visual acuity (BCVA) was 20/60 or better in 29 patients and 20/40 or better in 26 patients. In all 33 cases, the IOP was 22 mmHg or less without the use of anti-glaucoma medications (mean IOP was 15.1 mmHg). Postoperative corneal oedema occurred in 11 cases and anterior chamber inflammation was noted in nine cases. Both were resolved with standard medical therapy.

The authors of the study concluded that MSCIS with trypan blue staining is a safe and effective method of extracting cataracts in patients with phacolytic glaucoma.