title: Phacoemulsification Versus Manual Small Incision Cataract Surgery in Patients With Fuchs Heterochromic Iridocyclitis.
abstract: OBJECTIVE
  To compare the safety and efficacy of phacoemulsification and manual small incision cataract surgery (SICS) to treat cataract in patients with Fuchs heterochromic iridocyclitis (FHI).
  
  
  METHODS
  A randomized, double-masked, prospective, multicenter study.
  
  
  METHODS
  Consecutive patients with cataract after FHI were randomly assigned to have phacoemulsification or manual SICS by 1 of 2 surgeons experienced in both techniques. Complications (intraoperatively and postoperatively), operative time, visual acuities, endothelial cell counts, and surgically induced astigmatism were compared.
  
  
  RESULTS
  At 6 months, 65 (92.8%) patients in the phacoemulsification group and 70 (92.1%) in the manual SICS group had a corrected distance visual acuity of 20/63 or better (P = 0.974). Surgical time was significantly shorter in the SICS group (11.2 ± 2.4 minutes) than in the phacoemulsification group (14.2 ± 3.1 minutes) (P < 0.001). The mean surgically induced astigmatism was 0.8 ± 0.2 diopters (D) in the phacoemulsification group and 1.16 ± 0.2 D in the SICS group (P < 0.001). Endothelial cell counts at 1 week and at 6 months did not differ significantly in the phacoemulsification and SICS groups (t test; P = 0.133 and P = 0.032, respectively). Intraoperatively, 2 (3%) eyes randomized to receive phacoemulsification and 4 (5.3%) eyes randomized to receive SICS had posterior capsular rent (P = 0.465).
  
  
  CONCLUSIONS
  Both techniques achieved good visual outcomes with low rates of complications. Manual SICS may be a viable alternative for cataract management in patients with FHI in settings with limited access to phacoemulsification.
authors.affiliation: From the Departments of *Ophthalmology and †Pathology, School of Medical Sciences and Research, Sharda University, Greater Noida; and ‡Department of Ophthalmology, Rotary Eye Hospital, Maranda, Palampur, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Bhargava
authors.forename: Prachi
authors.initials: P
authors.lastname: Kumar
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Sharma
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Arora
mesh_terms: D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000209:etiology; D002387:Cataract Extraction / Q000009:adverse effects / Q000379:methods*; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015863:Iridocyclitis / Q000150:complications*; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D061646:Operative Time; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D014792:Visual Acuity