A clinical study of intra-operative complications of Phacoemulsification and their management

Background: Cataract is the leading cause of preventable blindness in the world, whereas cataract extraction with intraocular lens (IOL) implantation is perhaps the most effective surgical procedure in all of medicine. Smaller incision sizes achievable with techniques of Phacoemulsification with insertion of foldable intra ocular lenses or small phaco profile lenses have made postoperative recovery quicker with faster optical and physical rehabilitation of the patient. Aim: Present study was done to know the nature of intra-operative complications in patients undergoing Phacoemulsification and to identify the factors responsible for intra-operative complications during Phacoemulsification and to study the management of the same. Materials and methods: The study was conducted for a period of 1 year. It was prospective study comprised 100 patients who underwent Phacoemulsification. The patients were selected by simple random sampling and were followed up for a period of 6 weeks. Results: Majority of the patients were in the 51 to 60 years age group, females constituted the majority, being 57 in number (57.0%) as compared to males (43.0%). Posterior subcapsular cataract was the most common type of cataract in the present study and was seen in 36 eyes (36%). Pre-operative best corrected visual acuity ranged from 612 to counting fingers at one meter. 71.0% patients had pre operative best corrected visual acuity of 6/36 or better. Total Phacoemulsification time lasted less than one minute in 33% patients. In majority of the patients (63%), phaco time lasted between one to two minutes. Intra-operative complications occurred in 17.0% of the 100 cases included in the study. The most common complication encountered was difficulty in emulsifying an unexpectedly hard nucleus with conversion to small incision cataract surgery in 4 cases (4%). Incidence of complications seems to increase with increase in grade of the nuclear cataract. Post-operative best corrected visual acuity after 6 weeks of follow up was found to be 6/9 or better in 83% of cases and was 6/12 or better in 96% of cases. Conclusion: Good visual outcome obtained with Phacoemulsification and better management facilities available, shows this can be accepted and practiced as a routine for good visual outcome in cataract patients.