Phacoemulsification versus manual-small incision cataract surgery for brunescent cataracts: A retrospective analysis

Abstract

Background: Brunescent cataracts are associated with higher incidence of ocular comorbidities which predispose to intraoperative and postoperative complications. Objectives: To compare the surgical outcomes of Phacoemulsification (PE) and Manual Small Incision Cataract Surgery (MSICS) in Brunescent cataracts. Patients and Methods: Retrospective observational study of patients who underwent either MSICS or phacoemulsification for brunescent cataracts over a 1-year period were reviewed for complication rates and visual outcomes. Multiple logistic regression analysis using Stata software (version 11.0, Stata Corp LP) performed to find factors associated with surgical complications. P < 0.05 considered statistically significant. Results: A total of 959 eyes of 950 cases with brunescent cataract were reviewed of which 654 underwent MSICS and 305 underwent PE. A total of 53 intraoperative complications were encountered in both groups. PE group had 14 (2.95%) with the commonest being PCR in 9 cases. In the SICS group, 39 complications (5.96%) were noted with PCR in 16 followed by ZD in 12. Postoperative complications were noted in both groups with higher incidence of corneal edema in the PE group. Statistically significant difference in visual outcome was seen after 1 month with PE group (0.21±0.21) having better uncorrected visual acuity (P <0.001) compared to MSICS (0.44±0.26). Conclusions: For developing nations, where cost and training are the rate limiting factors and patients tend to present late with harder and complicated cataracts, MSICS is comparable to PE in terms of complication rates and visual outcomes.

Keywords

• brunescent cataract
• hard cataract
• manual small-incision cataract surgery
• phacoemulsification