SCLERAL TUNNEL COMPLICATIONS OF SMALL INCISION CATARACT SURGERY

Abstract

Cataract surgery is one of the most commonly performed surgeries in the world. The various techniques of cataract surgeries are- conventional extracapsular cataract extraction, small incision cataract surgery and phacoemulsification. Although the developing countries have shifted to phacoemulsification, SICS is still a widely 1,2 performed surgery in the developing world. SICS continues to prove useful in the developing countries where cost constraints are a factor in delivery of sight saving cataract 3 surgery. The results of SICS compares favorably with modern 4,5 phacoemulsification surgery. However there are various complications associated with SICS:1. Tunnel related complication (Premature entry and button hole) 2. complication during capsulorhexis- too small rhexis or extension of rhexis margin 3. Posterior capsular rupture 4. Descmet membrane tear 5. Zonular dialysis 6. Nucleus drop. Tunnel construction is a crucial part of SICS. A scleral tunnel; 5.5-7.5mm in length, 1.5 to 2mm behind the limbus, half to two third of scleral thickness, extending 1-2mm in cornea, with side pockets in sclera is self sealing in nature and requires no .6 sutures at the end of surgery Poorly constructed leads to button hole, premature entry into anterior chamber causing iris prolapse or nucleus may get stuck during delivery. In this case series we will discuss three cases who came to the clinic with late presentation of scleral tunnel related complication after SICS.