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Purpose: To study the demographic profile, contributing and precipitating factors, the severity of striate keratopathy and its relation with endothelial cell count, and evaluate the final treatment outcome of striate keratopathy. Methods: This observational analytical cohort study was conducted on 75 patients developing striate keratopathy after MSICS in the immediate postoperative period. Demographic profile, preoperative risk factors, and intraoperative complications were evaluated retrospectively. Postoperatively, slit-lamp grading of striate keratopathy was done, and specular microscopy of both eyes was taken. Treatment of striate keratopathy was initiated, and patients were followed up for 6 to 10 weeks for improvement. Results: Striate keratopathy was most commonly associated with surgeries performed by resident surgeons (92%), longer duration of surgery, associated predisposing factors, and intraoperative or postoperative complications. On postoperative day 1, the majority of patients had moderate and severe striate keratopathy (66% and 32%, respectively). It was associated with significant endothelial cell loss (ECL) at the final follow-up (P = 0.0016). Striate keratopathy resolved in 97.3% of patients, irrespective of the treatment with hypertonic saline. At 6 to 10 weeks, 92% of patients achieved a BCVA of ?6/9. Conclusion: A careful preoperative evaluation, adequate training of resident surgeons, meticulous surgical technique, and prompt management of postoperative complications can lead to a decrease in the incidence of striate keratopathy in the majority of cases. The use of hypertonic saline eye drops does not change the final outcome, and most cases resolve spontaneously during follow-up
RESUMO
Aims and Objectives: The aim is to study the different corneal complications after manual small-incision cataract surgery(MSICS) and their implication on the final visual outcome in the patients.Design: It is a prospective, hospital-based observational study.Materials and Methods: The present study was done among 100 patients who underwent MSICS with implantation of posteriorchamber intraocular lens implantation. Study was conducted over a period of 3 months between March 2018 and May 2018 inGovernment Medical College, Jammu. All patients with clinically significant visual cataract admitted in Ophthalmology Departmentof Government Medical College, Jammu, during the study period were included. The post-operative corneal complications andbest corrected visual acuity (BCVA) of the enrolled patients were reviewed on the 1st, 7th, 15th, 30th, and 45th post-operative day.Results: 100 eyes of 100 patients consisting of 69 males and 31 females who underwent MSICS with intraocular lens implantationin the Department of Ophthalmology were studied. Majority of the patients belonged to the 60–69 years age group whichconstitutes 35 of the total patients. Out of 100 patients, 26 had corneal complications. 24 patients had striate keratopathy – outof whom 16 patients had mild grade striate keratopathy (<10 Descemet’s membrane folds [DMF]) and 8 patients had severegrade striate keratopathy (>10 DMF). 1 patient had microcystic corneal edema, and 1 patient had Descemet’s membranedetachment. After 6 weeks of post-cataract surgery, it was found that 89 patients achieved a BCVA of 6/9 or better.Conclusions: Corneal complications such as striate keratopathy are transient and resolve usually by the end of 2 weeks.Therefore, it was concluded that detailed pre-operative planning and careful surgery can prevent most of these complications.