Visual outcomes and complications after phacoemulsification and small incision manual cataract surgery in two eye hospitals.

PURPOSE

To evaluate and compare the visual outcomes and complications of cataract surgery in two referral eye hospitals in southern Nigeria.

METHODS

Case records of patients who underwent elective cataract surgery at two referral eye hospitals from February 2017-2022 were collected retrospectively. Demographics, preoperative visual acuity (VA), anterior and posterior segment details, intraoperative and postoperative complications, VA at day 1, 1 week, and 1 month postoperatively were analyzed. The visual outcomes and complications of the phacoemulsification (PHACO) and manual small incision cataract surgery (MSICS) groups were compared. VA after cataract surgery was graded according to the WHO criteria.

RESULTS

A total of 3923 eyes underwent cataract surgery. The mean age was 65.30±17.50 years, and the majority (63.0%) were females. Approximately 1271 (32.4%) had unilateral cataracts, while 2652 (67.6%) were affected bilaterally. PHACO and MSICS were performed in 87.9% and 12.1% of cases, respectively. The proportion of eyes with good VA increased from 0.01% to 93.80% for PHACO-operated eyes and 2.50% to 92.30% for MSICS-operated eyes. Out of the 686 (17.49%) eyes with preexisting ocular pathology, the most common was glaucoma (281, 40.96%). More intraoperative complications occurred in the MSICS group (12.45%) compared to PHACO (5.89%), which was statistically significant (P-value<0.001). More postoperative complications (early and late) were seen in the MSICS group compared to the PHACO group, which was statistically significant.

CONCLUSION

Even though MSICS is performed more often in complicated cases, the study shows that experienced surgeons who perform PHACO and MSICS surgeries achieve similar visual acuity outcomes and complication rates.