Comparative Analysis of Postoperative Visual Outcomes Following Phacoemulsification and Small Incision Cataract Surgery

Evaluation of Anterior Segment Biometric Changes After Phacoemulsification Surgery with Intraocular Lens Implantation Measured with A-Scan Biometry

Background: Cataract is one of the most common preventable causes of blindness in the world, and the gold standard surgical treatment is phacoemulsification (PHACO) with intraocular lens (IOL) implantation. This study aimed to assess the changes in anterior segment biometry, particularly ACD, before and after PHACO with IOL, using A-scan biometry. Methods: This prospective observational study was conducted at Mugda Medical College Hospital, Dhaka, from July 2024 to December 2025. 100 patients who had uncomplicated PHACO with PCIOL implantation were enrolled. The A-scan ultrasonic biometer was used to measure ACD at baseline (preoperative) and on the 7th postoperative day (POD) and at one month postoperatively. Data were entered and analyzed on SPSS version 26. Results: The mean age was 61.8 ± 8.7 years, and 56% were male. Age-related cataract was the commonest diagnosis, 62%. Mean ACD increased significantly from 2.92 ± 0.28 mm preoperatively to 3.54 ± 0.31 mm on the 7th POD and 3.58 ± 0.30 mm at one month. The mean increases were 0.62 mm and 0.66 mm, respectively, both statistically significant, P < 0.001. Conclusions: PHACO, along with IOL, results in a clinically and statistically significant deepening of the ACD, especially in patients with shallow preoperative ACD. These biometric changes are well monitored by A-scan ultrasonic biometry.

Clinical Trends and Postoperative Complications in Cataract Surgery: A Six-Months Study

Background: “ Cataract is the leading cause of reversible blindness worldwide, with surgery being the only definitive treatment. Despite advances, variations in surgical patterns and postoperative complications remain clinically significant. Aim: To evaluate the patterns of cataract surgery and associated postoperative complications over six months. Methodology: A prospective observational study was conducted at the Department of Ophthalmology, Anugrah Narayan Magadh Medical College, Gaya ji, Bihar, India, including 80 patients aged ≥40 years undergoing cataract surgery. Data on demographics, surgical techniques, intraoperative and postoperative complications, and visual outcomes were recorded. Surgeries included phacoemulsification, ECCE, and MSICS. Postoperative follow-up extended to six months, and statistical analysis was performed using SPSS v27. Results: Patients were predominantly elderly, with a slight female predominance (52.5%). Phacoemulsification was the most common procedure (52.5%), with posterior chamber foldable IOLs implanted in 66.3% of cases. Intraoperative complications occurred in 13.7%, with posterior capsule rupture being most frequent. Postoperative complications were infrequent, with corneal edema (10%) and posterior capsule opacification (7.5%) being the most common. Conclusion: Phacoemulsification with posterior chamber foldable IOLs provides excellent visual outcomes with low complication rates. Patient selection, surgical expertise, and structured postoperative follow-up are critical for” optimal outcomes

A STUDY OF VISUAL OUTCOME OF CATARACT SURGERY IN PSEUDO EXFOLIATION AND TO EVALUATE ITS INTRAOPERATIVE AND POSTOPERATIVE COMPLICATIONS IN TERTIARY HEALTH CARE HOSPITAL

Background: Pseudo-exfoliation is an age-related systemic disorder characterized by deposition of abnormal fibrillar material on ocular tissues, leading to poor pupillary dilatation, zonular weakness, and increased risk of complications during cataract surgery. Cataract extraction in PXF eyes is therefore considered surgically challenging. The present study was undertaken to evaluate the visual outcome of cataract surgery in patients with pseudoexfoliation and to analyze associated intraoperative and postoperative complications.Methods: This hospital-based observational study was conducted in the Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal, over 18 months. A total of 58 patients aged ≥50 years with senile cataract associated with pseudoexfoliation were included. Detailed preoperative evaluation included BCVA (Best-Corrected Visual Acuity), intraocular pressure measurement, gonioscopy, slit-lamp examination, and cataract grading. All patients underwent SICS (Small Incision Cataract Surgery). Patients were followed postoperatively on day 1, day 3, and at 1 month for visual outcomesand complications.Results: The mean age of patients was 68.16 ± 11.70 years, with slight male predominance (51.72%). Poor pupillary dilatation was observed in 36.21% of cases. Intraoperative complications included zonular dialysis (6.8%), posterior capsule rupture (5.1%), vitreous loss (3.4%), and aphakia (1.7%). Early postoperative complications included corneal edema (32.76%), iritis (32.76%), raised intraocular pressure (24.14%), hyphema (8.62%), retained lens matter (5.17%), and IOL decentration (6.90%). At 1 month postoperatively, 91.38% of eyes achieved visual acuity between 6/6 and 6/12. Zonular dialysis showed a significant association with posterior capsule rupture (p < 0.0001).Conclusion: Pseudoexfoliation significantly increases the complexity of cataract surgery because of poor mydriasis and zonular instability. Careful preoperative evaluation, meticulous surgical technique, and appropriate postoperative management can achieve satisfactory visual outcomes, despite higher intraoperative and postoperative complication rates.

Surgical outcomes and complications of combined cataract phacoemulsification and silicone oil removal.

Cataract surgery without a phacoemulsification device during a humanitarian mission in benin: outcomes of manual small-incision cataract surgery and extracapsular cataract extraction

To describe preoperative triage and compare early postoperative complications after manual small-incision cataract surgery (MSICS) and extracapsular cataract extraction (ECCE) performed during a humanitarian mission in Benin, where no phacoemulsification device was available. Medical records and operative reports from 1,280 individuals examined during a humanitarian cataract mission in Porto-Novo, Benin, between November 25 and December 6, 2024, were retrospectively reviewed. Patients were triaged according to cataract-related best-corrected visual acuity, systemic risk factors, and ocular findings. After exclusion of patients with capillary glucose > 300 mg/dL, blood pressure > 200/120 mmHg, or preoperative retinal detachment, 287 patients were considered suitable for surgery and 125 underwent surgery. Patients were classified by technique as MSICS (n = 79) or ECCE (n = 46). Postoperative complications documented on postoperative day 1 or during the mission were compared using two-sided Fisher exact tests. Among the 125 operated patients, 79 underwent MSICS and 46 underwent ECCE. Aphakia occurred in 6 patients (4.8%), IOL dislocation in 3 (2.4%), marked endothelial edema in 11 (8.8%), postoperative IOP elevation in 12 (9.6%), and corneal suture dehiscence in 1 (0.8%). Marked endothelial edema was more frequent after ECCE than MSICS (8/46 [17.4%] vs. 3/79 [3.8%]; p = 0.018). No significant between-group differences were observed for aphakia (p = 0.192), IOL dislocation (p = 0.554), IOP elevation (p = 0.533), or corneal suture dehiscence (p = 0.368). No cases of IOL drop into the vitreous cavity, nuclear drop, intravitreal hemorrhage, toxic anterior segment syndrome, or endophthalmitis were observed in either group. In settings without a phacoemulsification device, MSICS and ECCE can be performed during humanitarian missions when experienced surgeons, careful preoperative triage, and appropriate postoperative assessment are available. MSICS may offer practical advantages where follow-up is limited because it generally avoids routine corneal suture removal. Because technique and surgeon were not independently separable in this nonrandomized study, the observed differences should not be interpreted as purely technique-related.

Comparative recovery of central corneal sensitivity after conventional phacoemulsification and femtosecond laser-assisted cataract surgery.

FLACS demonstrated faster and more complete recovery of corneal sensitivity by 90 days, but this neurosensory advantage may be particularly relevant for patients predisposed to ocular surface dysfunction.