Comparison of Visual Outcomes between Phacoemulsification and Small Incision Cataract Surgery

Abstract

Background: Globally, it is approximated that there are around 100 million cases of cataracts resulting in visual acuity of less than 6/60, and this number is expected to increase to approximately three to four times more for cases causing acuity of less than 6/18. Small incision cataract surgery is distinguished by its ability to provide early wound stability, reduce post-operative inflammation, eliminate suture-related complications, necessitate fewer post-operative visits, and have a milder impact on the corneal endothelium. This approach can be applied to all types of cataracts, unlike phacoemulsification, where careful case selection is particularly crucial, especially for less experienced surgeons. Objective: The objective of this study is to compare the visual outcome between Phacoemulsification and Small Incision Cataract surgery. Method: An experimental interventional study was conducted concurrently at Kulsoom Bai Valika Social Security Hospital and Sindh Govt. Qatar Hospital from January 2022 to January 2023. During this study, Phacoemulsification and Small Incision Cataract Surgery (SICS) procedures were performed. The research received approval from the relevant authorities at both hospitals. The study included a total of 200 participants, with one group undergoing SICS and the other group undergoing phacoemulsification, each consisting of 100 patients. To assess the relationship between the two procedures, a statistical analysis employing either the Chi-square or Fischer's test was conducted, and for LogMAR Mann-Whitney test with a P-value of 0.05 was deemed statistically significant. Results: The age difference between the two groups was found to be statistically insignificant, with a p-value of 0.158. The mean age for the SICS group was 54.96 ± 11 years, while the mean age for the Phacoemulsification group was 57.3 ± 12 years. In terms of gender distribution, the SICS group consisted of 47 females and 53 males out of 100 participants, while the Phacoemulsification group had 45 females and 55 males out of 100 participants. The results indicate that there was no significant difference in the mean best-corrected visual acuity (BCVA) between both groups, with a p-value of 0.36. In the Phacoemulsification and SICS groups, 86 and 83 patients out of 100, respectively, achieved a BCVA of 6/6-6/12 [LogMAR (0-0.3)]. Conclusion: The postoperative mean visual acuity in both the SICS and Phacoemulsification groups was found to be similar. Nevertheless, it's noteworthy that the SICS procedure offers significant cost-effectiveness and can be a viable option for cataract treatment, enabling economically disadvantaged patients to achieve excellent vision.