Post-Operative Complications After Manual Small Incision Cataract Surgery: A Systematic Review And Meta-Analysis
Published 2026 - 44th Congress of the ESCRS
Reference: PP21.07 | Type: Free paper | DOI: 10.82333/qn4n-5266
Authors: Dr Andreas Arnold-Vangsted* 1 , Dr Lars Christian Boberg-Ans 2 , Dr Bjarke Meinertz 3 , Dr Heriel Zacharia 4 , Dr Andrew Cyrus 5 , Prof. Van Charles Lansingh 6 , A/Prof. Gøril Elisabeth Boberg-Ans 7 , Prof. Yousif Subhi 8
1Department of Ophthalmology,University of Southern Denmark,Sønderborg,Denmark, 2Department of Ophthalmology,University of Southern Denmark,Sønderborg,Denmark;Ophthalmology,Innlandet Hospital Trust,Elverum,Norway;Red Synet / Eye Rescue,Copenhagen ,Denmark, 3Ophthalmology,University Hospital of Southern Denmark,Vejle,Denmark, 4Eye Rescue Clinic,Karatu Lutheran hospital, Karatu,Tanzania, United Republic of, 5Ophthalmology,Kilimanjaro Christian Medical Centre, Moshi,Tanzania, United Republic of, 6Moran Eye Center,University of Utah,Utah,United States;Public Health Sciences,University of Miami Miller School of Medicine,Miami,United States;Center for population Health research,National institute of public health research,Cuernavaca,Mexico;HelpMeSee,CRO,New Jersey ,United States, 7Red Synet / Eye Rescue,Copenhagen,Denmark, 8Department of Ophthalmology,University of Southern Denmark,Sønderborg,Denmark;Department of regional health Research,University of Southern Denmark,Odense,Denmark
Purpose
To estimate pooled rates of post-operative complications following manual small incision cataract surgery (MSICS).
Setting
Systemic review and meta-analysis
Methods
We systematically reviewed the literature and performed a meta-analysis on post-operative complications following MSICS. We searched 12 databases on 27 February 2026, adhering to PRISMA guidelines. Studies were included if they reported post-operative complications in MSICS patients. Eligible studies were primarily clinic-based case-control or cohort studies. Data extraction and risk-of-bias assessment were independently performed by two authors. A random-effects meta-analysis was used to estimate complication rates for common outcomes, including corneal edema, anterior uveitis, endophthalmitis, cystoid macular edema, posterior capsular opacification, and intraocular lens malposition.
Results
A total of 27 studies comprising 1,497,000 eyes undergoing MSICS were included. Study sizes ranged from 22 to 725,324 eyes. Early post-operative complications, particularly transient corneal edema and anterior segment inflammation, were reported more frequently than late complications. Sight-threatening complications such as endophthalmitis were consistently rare across studies. Reported complication rates varied substantially depending on surgical setting, surgeon experience, and duration of follow-up.
Conclusions
Post-operative complication rates following MSICS are low overall, with most complications occurring in the early post-operative period and resolving without long-term sequelae. These findings provide contemporary benchmark estimates and underscore the need for standardized definitions and follow-up reporting in MSICS outcome studies.