Umer Khan Orakzai, Mohammad Rafique Afridi, Nazullah, Hassan Yaqoob.
Manual Small Incision Cataract Surgery in Phacomorphic Glaucoma Complications and Challenges.
Ophthalmol Update Jan ;16(4):866-9.

Objective: To evaluate the visual outcome, the control of the intraocular pressure (IOP) and the complications in patients with phacomorphic glaucoma undergoing manual small incision cataract surgery. Materials and Methods: This was prospective, non-randomized interventional consecutive case series carried out in Khyber Medical Center Dabgari Garden Peshawar from 1st January to 30th June 2017. The study included all patients with phacomorphic glaucoma that presented in the center. A complete examination, medical and ophthalmological history, initial investigations, clinic-pathological findings, ophthalmic findings that included the best corrected visual acuity (BCVA), biomicroscopy with slit lamp, indirect ophthalmoscopy and Goldmann applanation tonometry were performed. Cataract extraction was performed on all affected eyes with the manual small incision cataract surgery procedure (MSICS). Results: A sample of 84 eyes with phacomorphic glaucoma underwent the manual small incision cataract surgery. Mean intraocular pressure (IOP) before surgery was 39.5 +- 14.3 mmHg and the mean IOP at the last follow-up was 13.8 +- 2.4 mmHg. A significant fall in IOP was observed and no long-term anti-glaucoma medication was required. A better visual outcome result was reported since the best corrected visual acuity (BCVA) was 20/40 or better in 61 patients. Fifteen eyes had corneal edema and 38 eyes had inflammation of the anterior chamber. Both conditions were resolved with standard medical therapy. Conclusion: To achieve a good visual outcome, manage IOP and the least complication in the treatment of phacomorphic glaucoma, manual small incision cataract surgery is safe and effective.

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