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J Cataract Refract Surg. 2010 Nov;36(11):1849-54. doi: 10.1016/j.jcrs.2010.05.025.

Phacoemulsification versus manual small-incision cataract surgery for white cataract.

Author information

1
Aravind Eye Hospital, Pondicherry, India. venkatesh@pondy.aravind.org

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.

PMID:
21029891
DOI:
10.1016/j.jcrs.2010.05.025
[Indexed for MEDLINE]

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