Visual Outcomes of Manual, Small-Incision Cataract Surgery in Patients with Coexisting Corneal Opacity

Purpose: The purpose of this study was to analyze the relationship between corneal opacity and vision acuity in patients with cataracts and coexisting corneal opacity by calculating the area of corneal opacities in the optical zone. Methods: This retrospective study involved 177 cataract patients (184 eyes) with corneal opacity who were successfully undergoing manual, small-incision cataract extraction and intraocular lens implantation. These patients were all treated by the same surgeon from December, 2011 to March, 2014 in our hospital. The 184 eyes analyzed were divided into three groups according to the area of corneal opacity in optical zone (O/OZ): Group 1: O/OZ < 30%, Group 2: 30% ≤ O/OZ < 60%, Group 3: O/OZ ≥ 60%. Results: Preoperative visual acuity of all 184 eyes examined was less than 20/70. Postoperative visual acuity differed significantly between the three groups. O/OZ was significantly correlated with preoperative visual acuity and visual acuity improvement (P = 0.001, P = 0.039). When O/OZ < 60%, postoperative visual acuity was associated with hardness of the lens nucleus. When O/OZ ≥ 60%, visual acuity depended on the area of corneal opacity rather than the hardness of the nucleus. Conclusion: Findings from this study demonstrate that manual small-incision cataract extraction and intraocular lens implantation for patients with cataract coexisting corneal opacity is feasible and safe. Visual acuity was significantly correlated with both O/OZ and lens opacity