PHACOEMULSIFICATION VERSUS SMALL INCISION CATARACT SURGERY -A SURGICAL OPTION FOR IMMATURE CATARACT IN DEVELOPING COUNTRIES

Abstract

Introduction: Several studies have shown comparable visual outcomes of SICS and phacoemulsification.
Phacoemulsification is the standard surgical procedure for cataract in developed countries whereas the technique of
cataract extraction varies in developing countries. Since the last decade small incision cataract surgery (SICS) has
become a popular technique of cataract surgery in India and other developing countries. Anecdotally, it is believed that
SICS is the appropriate technique for mature cataracts and phacoemulsification emulsification is more suitable for
immature cataracts. Several comparable studies have shown similar visual outcome of the two surgical techniques but
none of those previous studies had compared the surgical procedures on phacoemulsification suitable immature cataracts.
Objective: To compare the safety and efficacy of different types of surgical procedures (phacoemulsification versus SICS)
for cataract surgery in immature cataract.
Material and methods: A prospective randomized controlled trial was carried out involving 339 and 394 patients with
immature senile cataract selected for phacoemulsification and SICS, respectively.
Statistics: Mean values with standard deviations were calculated. P value of less than 0.05 was considered significant.
Results: There was no difference between the groups in terms of gender, age, and pre-operative visual acuity (p =
0.227). In group A, and in group B nearly 24.7% and 22.4% respectively of patients had good visual outcome (6/6-6/18).
Poor outcome (unaided visual acuity <6/18) was noticed in 75.3% patients from group A and in 77.6% patients from
group B.
Statistics: Data were computed and analyzed using the SPSS software program vs 23. The p value of < 0.05 was considered
significant.
Conclusion: There was no significant difference in visual outcome on first post-operative day in between
phacoemulsification and SICS technique. However, performing SICS was significantly faster. Small incision cataract
surgery with implantation of rigid PMMA lens is a suitable surgical technique to treat immature cataract in developing
countries.