Comparative outcomes of manual small incision cataract surgery and phacoemulsification performed by ophthalmology trainees in a tertiary eye care hospital in India: a retrospective cohort design.
OBJECTIVE
To compare the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification performed by ophthalmology trainees.


METHODS
Retrospective cohort design.


METHODS
Tertiary eye care centre.


METHODS
A total of 1029 subjects underwent cataract surgeries with MSICS technique or phacoemulsification by trainees during one quarter (July-September 2007). Only 484 (47%) subjects were males. Surgeries which were primarily large incision extracapsular or intracapsular cataract extraction and performed on patients less than 20 years of age were excluded.


METHODS
The postoperative best corrected visual acuity (BCVA) along with the rates and types of complications were compared between both the groups.


RESULTS
A total of 1029 surgeries were performed by 22 resident surgeons. In all, 522 (50.7%) were done using MSICS technique and 507 (49.2%) were done by phacoemulsification. Those in the MSICS group were significantly older (age >70 years; 5.7% vs 3.4%; p<0.001) and had worse preoperative visual acuity (visual acuity <6/60; 69.3% vs 40.4%; p<0.001). Postoperatively, the number of patients having BCVA≥6/12 was similar in both the groups (84.3% vs 88%; p=0.09). The complication rates were higher in MSICS group (15.1% vs 7.1%, p<0.001). Most common risk factor for poor outcome (postoperative BCVA<6/60) in both the groups was presence of associated ocular pathologies (OR 7.4 95% CI 3.4 to 16.4) and having a complications (OR 5.7 95% CI 3.0 to 10.8).


CONCLUSIONS
Although the complication rate was higher in the MSICS group, there was no difference in BCVA in both the groups.
Allen Foster Community Eye Health Research Centre, International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India.
Rohit C
RC
Khanna
Srivalli
S
Kaza
Ghanshyam
G
Palamaner Subash Shantha
Virender S
VS
Sangwan