Visual Outcomes and Intraocular Pressure Control Following Manual Small Incision Cataract Surgery in Patients with Lens-Induced Glaucoma: A Prospective Analytic Study from a Tertiary Care Center in Rajasthan, India

Abstract

Background: Lens-induced glaucoma (LIG) is a vision-threatening secondary glaucoma associated with advanced cataract. Prompt surgical intervention is essential to reduce intraocular pressure (IOP), relieve symptoms, and restore visual function. Manual Small Incision Cataract Surgery (MSICS) remains a preferred treatment option in resource-limited settings because of its safety, effectiveness, and cost-efficiency.

Objective: To evaluate visual outcomes and IOP control following MSICS in patients with lens-induced glaucoma.

Methods: A hospital-based prospective analytic study was conducted in the Department of Ophthalmology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, from June 2024 to December 2025. Forty patients diagnosed with lens-induced glaucoma who underwent MSICS were included. Demographic characteristics, clinical presentation, preoperative findings, visual acuity, and IOP measurements were recorded. Patients were followed on postoperative day 1, week 1, month 1, and month 3. Statistical analysis was performed using SPSS version 26.

Results: The mean age of patients was 64.1 ± 8.9 years, with females accounting for 60% of cases. Phacomorphic glaucoma was the most common subtype (75%), followed by phacolytic glaucoma (20%). Mean IOP decreased significantly from 40.3 ± 6.2 mmHg at presentation to 19.5 ± 5.57 mmHg at three months postoperatively. Visual acuity improved substantially following surgery. At presentation, all patients had BCVA below 3/60, whereas at three months, 80% achieved BCVA of 6/36 or better. The majority of patients demonstrated satisfactory visual rehabilitation and effective IOP control.

Conclusion: MSICS is a safe and effective surgical modality for the management of lens-induced glaucoma. Early intervention provides significant improvement in visual acuity and long-term reduction of intraocular pressure, thereby minimizing the risk of irreversible glaucomatous damage.