Venkatesh R, Tan CSH, Sengupta S, Ravindran RD, Krishnan KT, Chang DF. Phacoemulsification versus manual small-incision cataract surgery for white cataract.
J Cataract Refract Surg 2010;
36:1849-54. [PMID:
21029891 DOI:
10.1016/j.jcrs.2010.05.025]
[Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2010] [Revised: 05/17/2010] [Accepted: 05/18/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE
To compare the safety and efficacy of phacoemulsification and manual small-incision cataract surgery (SICS) to treat white cataracts in southern India.
SETTING
Aravind Eye Hospital, Pondicherry, India.
DESIGN
Randomized prospective study.
METHODS
Consecutive patients with white cataract were randomly assigned to have phacoemulsification or manual SICS by 1 of 3 surgeons experienced in both techniques. Surgical complications, operative time, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, and surgically induced astigmatism were compared.
RESULTS
On the first postoperative day, the UDVA was comparable in the 2 groups (P = .805) and the manual SICS group had less corneal edema (10.2%) than the phacoemulsification group (18.7%) (P = .047). At 6 weeks, the UDVA was 20/60 or better in 99 patients (87.6%) in the phacoemulsification group and 96 patients (82.0%) in the manual SICS group (P = .10) and the CDVA was 20/60 or better in 112 (99.0%) and 115 (98.2%), respectively (P = .59). The mean time was statistically significantly shorter in the manual SICS group (8.8 minutes ± 3.4 [SD]) than in the phacoemulsification group (12.2 ± 4.6 minutes) (P<.001). Posterior capsule rupture occurred in 3 eyes (2.2%) in the phacoemulsification group and 2 eyes (1.4%) in the manual SICS group (P = .681).
CONCLUSIONS
Both techniques achieved excellent visual outcomes with low complication rates. Because manual SICS is significantly faster, less expensive, and less technology-dependent than phacoemulsification, it may be a more appropriate technique in eyes with mature cataract in the developing world.
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