Munir Amjad Baig, Ijaz Anwar, Rabeeya Munir.
Analysis between Manual Small Incision Catarac and Conventional Extra Capsular Cataract Extraction.
Pak J Med Health Sci Jan ;12(1):323-6.

Background: People with cataracts living in developing countries, have limited facilities to cope with high demands of cataract surgery. These countries share the largest backlog of cataract surgeries, which are intumescent, mature and hyper-mature lenses (white cataracts) . Aim: To compare both surgical procedures for the rehabilitation of cataract patients in high volume eye hospital setting. Methods: In a single masked randomised controlled clinical trial, 360 willing patients, aged 40–80 years, with operable cataract were assigned to receive either MSICS (group 1) or ECCE (group 11) in Federal Government Services Hospital Islamabad during Jan 2012 - Dec 2012 by a single surgeon after approval from hospital Ethical committee. Intraoperative and postoperative complications were graded and scored according to the Oxford Cataract Treatment and Evaluation Team (OCTET) recommendations. In all comparisons, a p<0.05 was considered statistically significant .Results: Among 360 first operated eyes, 184 patients of equal gender underwent MSICS while 176 patients had ECCE with PCIOL implantation. Mean age at surgery was 64 years with male predominance of 51.1% . The complications based on OCTET definitions showed that 69 (19.1%) patients had Grade1, 15(4.1%) had Grade II and 4(1.1%) had Grade III complications. Follow-up rates were comparable between both groups. Both groups achieved good visual results with minimal complications but group 1 had better Initial visual recovery. Conclusion: A huge backlog of cataract blindness exists in the developing world. Manual small incision cataract surgery (MSICS) and extra capsular cataract extraction (ECCE) with intra ocular lens implantation (IOL) can deal with this situation.

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