[Phacoemulsification versus manual small incision cataract surgery: Anatomic and functional results]

Area of Science:

• Ophthalmology
• Surgical Techniques
• Biomedical Engineering

Background:

• Cataract surgery is a common procedure to restore vision.
• Phacoemulsification (PHACO) and small incision cataract surgery (SICS) are two prevalent surgical methods.
• Endothelial cell health and refractive outcomes are key indicators of surgical success.

Purpose of the Study:

• To compare the impact of PHACO and SICS on corneal endothelial cell density and morphology.
• To evaluate and compare the refractive results, including visual acuity and induced astigmatism, between PHACO and SICS.

Main Methods:

• A prospective randomized study involving 57 patients (63 eyes) with senile or presenile cataracts (LOCS III class 2-4).
• Patients were randomized into PHACO (33 eyes) and SICS (30 eyes) groups.
• Data on endothelial structure and refractive outcomes were collected prospectively with a minimum 6-month follow-up; statistical analysis used SPSS 18.0.

Main Results:

• No significant difference in preoperative endothelial cell density between groups (P=0.207).
• Significant endothelial cell loss occurred in the immediate postoperative period for both groups, with a notable decrease by Day 15 (P<0.001).
• Mean best-corrected visual acuity was excellent (0.057 log MAR) for all patients; however, SICS resulted in significantly higher induced astigmatism (1.51 D) compared to PHACO (1.08 D) (P=0.001).

Conclusions:

• Both PHACO and SICS provide excellent anatomical and refractive results in cataract surgery.
• SICS demonstrates advantages over PHACO in terms of surgical speed, cost-effectiveness, and technological independence.
• SICS is particularly well-suited for managing dense cataracts and performing high-volume cataract surgeries.