Phacoemulsification Versus Manual Small Incision Cataract Surgery in Hard Nuclear Cataracts

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Ragni Kumari, Nitesh Pradhan, Sunil Kumar Gupta, Gaurav Dubey , Aysworya Mohapatra, Jitendra Singh , Jamshed Ali, Mrinal Ranjan Srivastava , Rajiv Janardhanan


Objective: The aim of this study was to compare the clinical outcomes of phacoemulsification with that of manual small incision cataract surgery (MSICS) in cases of hard nuclear cataract. Methods: 160 of 160 patients with gradual painless diminution of vision, diagnosed as senile nuclear cataract grade 4 or higher according to Lens Opacities Classification System III (brown cataract), were studied. These eyes were divided randomly into two groups: group A included 80 eyes treated by phacoemulsification by the vertical chopping technique and group B included 80 eyes treated by MSICS by the viscoexpression technique. Results:  One day postoperatively, the corrected distance visual acuity was at least 6/18 in 42 (52.5%) patients in the SICS group and in 18 (22.5%) patients in the phacoemulsification group. The difference was statistically significant (P=0.01). A postoperative increase in intraocular pressure was recorded in 2 (2.5%) case in the phacoemulsification group. On the first postoperative day, 22 (27.5%) cases in the SICS group and 26 (32.5%) cases in the phacoemulsification group developed postoperative iritis, with no statistically significant difference between both the groups. Conclusion: Both phacoemulsification and SICS achieved comparable and excellent visual outcomes for treatment of hard brown cataract, with lower complications

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