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

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


Aims: 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).

Methods: 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.

Results: 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).

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

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cataract / pathology
  • Cataract Extraction / adverse effects
  • Cataract Extraction / methods*
  • Coloring Agents
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Trypan Blue
  • Visual Acuity


  • Coloring Agents
  • Trypan Blue