title: Phacoemulsification versus manual small-incision cataract surgery for age-related cataract: meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  To compare outcomes of phacoemulsification (PE) with manual small-incision cataract surgery (MSICS) for age-related cataract.
  
  
  METHODS
  Meta-analysis.
  
  
  METHODS
  Patients from previously reported randomized controlled trials (RCTs) of PE and MSICS with clinical outcomes.
  
  
  METHODS
  A comprehensive literature search of Cochrane Library, PubMed and EMBASE to identify relevant RCTs comparing PE and MSICS. A meta-analysis was performed on the results and a RevMan 5.0 software (version 5.0; Cochrane Collaboration, Oxford, UK) was used for data analysis.
  
  
  METHODS
  Primary outcome measures included best corrected vision acuity (BCVA), uncorrected visual acuity (UCVA). Secondary outcome measures included surgically induced astigmatism (SIA), percentage of endothelial cell count (ECC) loss and complications.
  
  
  RESULTS
  Six RCTs describing a total of 1315 eyes were identified. There were no significant differences between the techniques regarding the BCVA 6/9 or better (P = 0.69) and less than 6/18 (P = 0.68), percent of ECC loss (P = 0.45), intraoperative or postoperative complications (P = 0.44 and P = 0.87, respectively). However, a greater proportion of patients in the PE group had final UCVA ≥ 6/9 (P = 0.03), whereas a greater proportion of patients in the MSICS group had final UCVA < 6/18 (P = 0.03). Moreover, PE group induced less SIA (P < 0.00001).
  
  
  CONCLUSIONS
  PE is superior to MSICS in UCVA and causes less SIA, but there were no significant differences in visual rehabilitation, ECC loss and complication rates between the two techniques.
authors.affiliation: The Third Affiliated Hospital, Ruian People's Hospital of Wenzhou Medical College, Zhejiang, China.
authors.forename: Jia-yu
authors.initials: JY
authors.lastname: Zhang
authors.forename: Yi-fan
authors.initials: YF
authors.lastname: Feng
authors.forename: Jian-qiu
authors.initials: JQ
authors.lastname: Cai
mesh_terms: D000375:Aging / Q000502:physiology*; D001251:Astigmatism / Q000503:physiopathology; D002386:Cataract / Q000503:physiopathology / Q000534:rehabilitation*; D002387:Cataract Extraction; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D018918:Phacoemulsification; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014786:Vision Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology