Visual and Refractive Outcomes of Phacoemulsification Versus Manual Small Incision Cataract Surgery in Senile Cataract
Author(s): Ludmila Rudaba Mimfa, Shams Mohammed Noman, Md Muarraf Hossain
Background: Cataract is the leading cause of reversible blindness worldwide and even senile cataract is the most common type in aging population. Both phacoemulsification and MSICS are among professionally applied surgical steps, but their relative visual and refractive outcome continues to remain a matter of interest and evaluation.
Aim: To Compare visual and refractive results after phacoemulsification with manual small incision cataract surgery in cases of senile cataract.
Materials and Methodology: This work is an observational study conducted at the Chevron Eye hospital and research Centre), Chevron Eye Hospital and Research Center (CEHRC), Chattogram. The sampling was done from January 2025 to March 2025 with a total of 200 senile cataract patients equally randomized in Phacoemulsification and MSICS groups. Best-corrected visual acuity (BCVA) and refraction were measured at preoperative, one month postoperatively to classify the surgical results in accordance with the WHO's criteria. The ethical principles were in accordance with the Declaration of Helsinki. The study was approved by Institutional Ethics Committee of CEHRC. All subjects provided written informed consent. Data was analyzed using SPSS version 26.0, employing pair t-tests and a P-value < 0.05 deemed to be significant statistically difference.
Results: Two hundred cases of senile cataract were enrolled that included 100 patients each in the phacoemulsification and MSICS groups. The average age and gender distribution were balanced between groups. Six sixteenth postoperative best-corrected visual acuity (6/6-6/18) was achieved in 46% phaco cases and 40% of MSICS cases, with significantly better vision than baseline preoperatively (p < 0.001). Phacoemulsification produced reduced amounts of postoperative astigmatism with a greater percentage of with-the-rule (WTR) cylinder relative to MSICS (p = 0.02). Mean LogMAR visual acuity significantly improved commonly in both groups (p < 0.001); suggesting that two surgical procedures can achieve visual rehabilitation, but phacoemulsification had slight superior refractive stability.
Conclusion: Both phacoemulsification and manual SICS have excellent postoperative visual outcomes in patients undergoing cataract surgery for senile cataracts. Phacoemulsification provided marginally better early visual results and less postoperative astigmatism, while MSICS was a safe, efficient and affordable alternative applicable to resource poor regions.