The Pan-American Journal of Ophthalmology (Jan 2022)

Safety and efficacy of manual small incision cataract surgery and phacoemulsification: a retrospective, comparative study in a low-to-middle-income country

  • Mario Renato Papa-Vettorazzi,
  • José Benjamin Cruz-Rodríguez,
  • Gladys Lucia Silva-Linares,
  • Nuno Moura-Coelho,
  • Nicolás Yee-Melgar

DOI
https://doi.org/10.4103/pajo.pajo_115_21
Journal volume & issue
Vol. 4, no. 1
pp. 11 – 11

Abstract

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Purpose: To compare the efficacy and safety of manual small incision cataract surgery (mSICS) versus phacoemulsification in a referral center from a low-to-middle-income country. Subjects and Methods: A retrospective cohort of 177 eyes with visually significant cataract and ≤1.0 diopter (D) of keratometric astigmatism was intervened during 2017 by four surgeons either by mSICS or by phacoemulsification. Last follow-up was at 4–6 weeks. Outcome measures included postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive cylinder, spherical equivalent (SE), complications, and re-interventions. Results: The mSICS group included 107 eyes; the phacoemulsification group included 70 eyes. UDVA was comparable between both groups; 89.6% in the mSICS group and 95.7% in the phacoemulsification group achieved a UDVA ≥6/18 (20/60) (P = 0.06). CDVA was comparable between both groups; 100% in the mSICS cohort and 98.6% in the phacoemulsification cohort had a CDVA ≥6/18 (20/60) (P = 0.26). Although the absolute difference in postoperative refractive astigmatism between both groups was small, it was statistically significant in favor of the phacoemulsification group (P = 0.02). Postoperative refractive SE was also comparable between both cohorts (P = 0.64). One intraoperative complication was found in the phacoemulsification group (1.4%), with no complications in the mSICS group. However, there were six reoperations in the mSICS cohort (5.6%) and no reoperations in the phacoemulsification one. Conclusions: Both mSICS and phacoemulsification achieved excellent visual outcomes with low complication rates. Phacoemulsification gives better UDVA and lower postoperative refractive astigmatism in a larger proportion of patients at 4–6 weeks.

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