Naseer Raja, Muhammad Khizar Niazi.
Phacoemulsification versus Extracapsular Cataract extraction: the visual outcome.
Pak J Surg Jan ;19(2):77-81.

This comparative study was carried out on patients with age related cataract in our unit between Sept.2001 to March 2003. Out of a total of 232 patients, 120 underwent planned extracapsular cataract extraction with intraocular lens implant (Group-A), while 112 received small incision surgery by phacoemulsification with intraocular lens implant (Group-B) by the main author. The main comparative outcomes studied were visual acuity, refraction, and complication rates at each stage of follow up, that was conducted at 3 weeks, 6 weeks, 3 months, 6 months and one year after surgery. Unaided visual acuity of 6/9 or better was seen in eighty eyes (66%) in Group-A as compared to ninety-one (81%) eyes in Group-B at three months. More patients were satisfied in Group-B due to quick recovery as compared to Group-A (p<0.14). The mean postoperative astigmatism was +2.25 (± 1.7) among 120 eyes in Group-A, as compared to +0.5 (± 0.49) among 112 eyes in Group-B. At six months, however, the difference in mean astigmatism in both the groups was less than 0.25 (± 0.5). Final visual acuities reached 6/12 or greater in 77% of Group-A patients as compared to 81% patients of Group-B. The complication rates were slightly higher in Group-B (p0.21), but did not adversely affect the outcome of the refractive result. It is therefore concluded that phacoemulsification, though appealing with its fast visual recovery, is clinically superior to extracapsular surgery only in the initial four to six months. Extracapsular surgery if performed by expertise has equally good results and has fewer complications

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