Maximizing surgical safety: Approaches to prevent intraoperative complications in manual small incision cataract surgery (MSICS)

In manual small incision cataract surgery (MSICS), the occurrence of intraoperative complications is a recognized concern that can impact both surgical outcomes and patient safety. MSICS is widely practiced as a cost-effective alternative for cataract extraction, especially in resource-limited settings where access to phacoemulsification may be limited. However, it is important to acknowledge that MSICS is not entirely risk-free. Complications during the surgery can arise due to factors such as surgeon experience, surgical technique, instrument handling, and patient-specific anatomical variations. Common complications encountered in MSICS include posterior capsule rupture, corneal burns, iris trauma, wound-related issues, vitreous loss, and anterior chamber hemorrhage. It is crucial for surgeons to have a comprehensive understanding of the background and potential risks associated with these complications. This knowledge allows them to proactively implement preventive strategies, optimize surgical outcomes, and prioritize patient safety during MSICS procedures. Ongoing efforts in the field of cataract surgery aim to improve outcomes by advancing surgical techniques, refining equipment, and enhancing postoperative care. Through research and innovation, the goal is to minimize complications and achieve optimal visual outcomes for individuals undergoing cataract surgery. This video discusses the possible complications and provides practical strategies to minimize the same at each step of the MSICS procedure. The video demonstrates the potential complications that can occur intraoperatively during MSICS and highlights the significance of careful technique and practical strategies for prevention. In resource-poor settings, MSICS is widely used as the predominant technique for cataract surgeries. Despite being a cost-effective alternative, MSICS offers comparable visual outcomes to phacoemulsification with low complication rates. This video emphasizes the importance of proactive measures and careful technique in preventing complications, thereby improving patient safety and outcomes in MSICS. https://youtu.be/hOAMJpC67C0.