Phacoemulsification versus endocapsular cataract extraction in a unique cohort of patients

The visual recovery and refractive results of 33 consecutive patients (66 eyes) undergoing standard endocapsular cataract extraction in one eye and simultaneous phacoemulsification in the fellow eye are reported. One surgeon performed all the operations. Surgically induced astigmatism was evaluated for the two techniques in terms of: (1) the proportion of eyes with a refractive cylinder of 1.5 dioptres (D) or less; (2) the interocular difference in post-operative astigmatism. Eyes undergoing phacoemulsification had a significantly lower mean induced cylinder (paired Student's t-test: t = 3.729; p < 0.001) and were more likely to exhibit a cylinder of 1.5 D or less (chi-squared test with Yates' correction: chi 2 = 7.88; p < 0.01) than the nuclear expression group. For paired eyes less post-operative astigmatism (Wilcoxon's signed rank test: T = 92; p < 0.01) was seen in the phacoemulsification eye. At the time of the last post-operative assessment a significantly higher proportion of phacoemulsified eyes achieved a corrected Snellen visual acuity of 6/6 or better than their fellow eyes (McNemar's test: p < 0.01). The results of this unique cohort of patients confirm the beneficial effects of phacoemulsification on astigmatism and visual outcome in the early post-operative period.