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Eye (Lond). 2009 May;23(5):1155-7. doi: 10.1038/eye.2008.190. Epub 2008 Jun 20.

Safety and efficacy of manual small incision cataract surgery for brunescent and black cataracts.

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Cataract Microsurgery Service, Aravind Eye Hospital, Pondicherry, India.



To evaluate the safety, visual outcome and complications of manual small incision cataract surgery (MSICS) in the treatment of patients with brunescent and black cataract (BBC).


In a non-randomised interventional case series, 102 consecutive patients with BBC underwent cataract extraction by MSICS, with staining of the anterior capsule by trypan blue.


Of the 102 eyes with BBC, MSICS was performed through superior scleral tunnel (SST) in 31 eyes (30.4%) and through temporal scleral tunnel (TST) in 71 eyes (69.6%). The main intraoperative complication was posterior capsule rupture in two patients (2.0%). Postoperatively, 20 eyes (19.6%) developed corneal oedema. Mild iritis was seen in six eyes (5.9%) and moderate iritis with fibrin membrane formation occurred in three eyes (2.9%). On the 40th postoperative day, 80 patients (78.4%) achieved uncorrected visual acuity of 6/18 or better, and 99 (97.1%) had best-corrected visual acuity of 6/18 or better. Patients in the SST group had significantly higher postoperative astigmatism compared to those in the TST group (-1.08 D vs -0.72 D, P=0.017).


MSICS with trypan blue staining of the anterior capsule is a safe and effective method of cataract extraction for patients with BBC.

[Indexed for MEDLINE]

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