Comparative Evaluation of Visual Outcomes, Intraocular Pressure Control, and Complications Following Temporal Manual Small Incision Cataract Surgery Versus Phacoemulsification in Eyes with Previous Trabeculectomy
Keywords:
Trabeculectomy, Cataract Surgery, Phacoemulsification, Manual Small Incision Cataract Surgery, Intraocular Pressure, Visual Outcome.Abstract
Background: Cataract formation is a common late complication following trabeculectomy and may adversely affect visual function in glaucoma patients. Cataract surgery in eyes with previous trabeculectomy requires careful surgical planning to preserve filtering bleb function and maintain intraocular pressure (IOP) control. Temporal Manual Small Incision Cataract Surgery (MSICS) and temporal phacoemulsification are commonly performed procedures; however, comparative evidence regarding their outcomes in post-trabeculectomy eyes remains limited.
Aim: To compare visual outcomes, intraocular pressure control, keratometric changes, and complications following temporal MSICS and phacoemulsification in eyes with previous trabeculectomy.
Methods: This prospective interventional study included 60 patients with visually significant cataract and prior trabeculectomy. Patients were allocated into two groups: Group A underwent temporal MSICS (n=30), while Group B underwent temporal phacoemulsification (n=30). Best-corrected visual acuity (BCVA), intraocular pressure, keratometry readings, and surgical complications were evaluated preoperatively and during postoperative follow-up.
Results: The mean age of participants was 62.01 ± 7.8 years. Both groups demonstrated a transient rise in IOP on postoperative day 1, followed by stabilization near preoperative values by one month. Significant keratometric changes were observed in both groups (p<0.01). Visual acuity improved substantially in both groups; however, phacoemulsification showed comparatively better visual recovery at one month. Intraoperative complications occurred more frequently in the MSICS group than in the phacoemulsification group.
Conclusion: Both temporal MSICS and phacoemulsification are safe and effective procedures for cataract extraction in eyes with previous trabeculectomy. Phacoemulsification provides superior visual rehabilitation with fewer complications while maintaining satisfactory postoperative IOP control.
