Manual Small Incision Cataract Surgery Under the Lens: A Prospective Study on Surgical Complications and Visual Prognosis

Sarita Verma, Semone Singhal, Neha Pednekar, Swati Agarwal, Anil Kumar Srivastava

Abstract: Purpose: To evaluate the incidence and types of perioperative complications associated with Manual Small Incision Cataract Surgery (MSICS) and to assess their impact on short-term postoperative visual outcomes. Methods: This prospective observational study was conducted at a tertiary care centre in Uttar Pradesh, India, from January 2023 to June 2024. A total of 150 patients aged 40?75 years with senile cataract underwent MSICS. Comprehensive preoperative evaluation included BCVA, IOP, slit-lamp biomicroscopy, and fundus examination. A uniform surgical technique was used under peribulbar anaesthesia. Patients were followed postoperatively on Day 1, Day 3, Day 7, Week 3, and Week 6. Complications were documented and visual outcomes assessed using Snellen and LogMAR charts. Statistical analysis was performed to determine differences in BCVA between those with and without complications. Results: Intraoperative complications were noted in 14 patients (9.3%), with the most frequent being capsulorhexis extension (4.7%) and posterior capsule rupture (2%). Postoperative complications occurred in 16 patients (10.7%), most commonly corneal oedema (4.7%) and Descemet?s membrane folds (3.3%). At 6 weeks, 97.3% of patients achieved BCVA of 6/6?6/9. Mean LogMAR BCVA in patients with complications (0.21 ? 0.14) was significantly poorer than in those without complications (0.08 ? 0.07; p = 0.0087), although most patients demonstrated substantial visual improvement. Conclusion: MSICS is a robust, cost-effective, and scalable technique for cataract surgery in resource-limited settings. Although perioperative complications can influence early visual recovery, timely identification and management often result in favorable outcomes. The study reinforces the value of structured MSICS training and appropriate case selection to minimize risks.

Keywords: MSICS, cataract surgery, perioperative complications, visual acuity, low-resource settings, posterior capsule rupture, BCVA

How to Cite?: Sarita Verma, Semone Singhal, Neha Pednekar, Swati Agarwal, Anil Kumar Srivastava, "Manual Small Incision Cataract Surgery Under the Lens: A Prospective Study on Surgical Complications and Visual Prognosis", Volume 14 Issue 8, August 2025, International Journal of Science and Research (IJSR), Pages: 651-655, https://www.ijsr.net/getabstract.php?paperid=SR25812164938, DOI: https://dx.doi.org/10.21275/SR25812164938