A prospective randomized clinical trial of phacoemulsification vs manual sutureless small-incision extracapsular cataract surgery in Nepal.
OBJECTIVE
To compare the efficacy and visual results of phacoemulsification vs manual sutureless small-incision extracapsular cataract surgery (SICS) for the treatment of cataracts in Nepal.


METHODS
Prospective, randomized comparison of 108 consecutive patients with visually significant cataracts.


METHODS
settings: Outreach microsurgical eye clinic. patients: One hundred eight consecutive patients with cataracts were assigned randomly to receive either phacoemulsification or SICS. intervention Cataract surgery with implantation of intraocular lens. main outcome measures: Operative time, surgical complications, uncorrected and best-corrected visual acuity (BCVA), astigmatism, and central corneal thickness (CCT).


RESULTS
Both surgical techniques achieved excellent surgical outcomes with low complication rates. On postoperative day 1, the groups had comparable uncorrected visual acuity (UCVA) (P = 0.185) and the SICS group had less corneal edema (P = 0.0039). At six months, 89% of the SICS patients had UCVA of 20/60 or better and 98% had a best-corrected visual acuity (BCVA) of 20/60 or better vs 85% of patients with UCVA of 20/60 or better and 98% of patients with BCVA of 20/60 or better at six months in the phaco group (P = 0.30). Surgical time for SICS was much shorter than that for phacoemulsification (P < .0001).


CONCLUSIONS
Both phacoemulsification and SICS achieved excellent visual outcomes with low complication rates. SICS is significantly faster, less expensive, and less technology dependent than phacoemulsification. SICS may be the more appropriate surgical procedure for the treatment of advanced cataracts in the developing world.
Ruit
Sanduk
S
Tilganga Eye Center, Bagmati Pul, Gaushala, Kathmandu, Nepal.
Tabin
Geoffrey
G
Chang
David
D
Bajracharya
Leena
L
Kline
Daniel C
DC
Richheimer
William
W
Shrestha
Mohan
M
Paudyal
Govinda
G
D000368:Aged; D002386:Cataract / Q000503:physiopathology / Q000628:therapy; D002387:Cataract Extraction / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009390:Nepal; D018918:Phacoemulsification / Q000191:economics / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology