Audit of small-incision cataract surgery using an anterior chamber maintainer

Purpose To assess the results of small-incision cataract surgery with intraocular lens implantation using an anterior chamber maintainer (ACM) performed between March 1997 and December 1998. Method A retrospective audit was performed of all 300 consecutive patients who underwent extracapsular cataract extraction using a 6 mm scleral tunnel incision, anterior chamber maintainer and manual fragmentation of the nucleus. Results Ninety per cent of patients had a gain in visual acuity at the end of 3 months. The rate of posterior capsule opacification was comparable to the results of the National Cataract Surgery Survey (RCO 1993), i.e. 13%, but the rate of corneal endothelial decompensation and endophthalmitis was marginally higher. Conclusion Appropriate selection of cases, meticulous wound closure and subconjunctival antibiotics at the end of surgery make this an acceptable alternative small-incision closed-system low-cost procedure where phacoemulsification is not available.