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Introduction: Several studies have shown comparable visual outcomes of SICS and phacoemulsification. Phacoemulsification is the standard surgical procedure for cataract in developed countries whereas the technique of cataract extraction varies in developing countries. Since the last decade small incision cataract surgery (SICS) has become a popular technique of cataract surgery in India and other developing countries. Anecdotally, it is believed that SICS is the appropriate technique for mature cataracts and phacoemulsification emulsification is more suitable for immature cataracts. Several comparable studies have shown similar visual outcome of the two surgical techniques but none of those previous studies had compared the surgical procedures on phacoemulsification suitable immature cataracts. Objective: To compare the safety and efficacy of different types of surgical procedures (phacoemulsification versus SICS) for cataract surgery in immature cataract. Material and methods: A prospective randomized controlled trial was carried out involving 339 and 394 patients with immature senile cataract selected for phacoemulsification and SICS, respectively. Statistics: Mean values with standard deviations were calculated. P value of less than 0.05 was considered significant. Results: There was no difference between the groups in terms of gender, age, and pre-operative visual acuity (p = 0.227). In group A, and in group B nearly 24.7% and 22.4% respectively of patients had good visual outcome (6/6-6/18). Poor outcome (unaided visual acuity <6/18) was noticed in 75.3% patients from group A and in 77.6% patients from group B. Statistics: Data were computed and analyzed using the SPSS software program vs 23. The p value of < 0.05 was considered significant. Conclusion: There was no significant difference in visual outcome on first post-operative day in between phacoemulsification and SICS technique. However, performing SICS was significantly faster. Small incision cataract surgery with implantation of rigid PMMA lens is a suitable surgical technique to treat immature cataract in developing countries. [ABSTRACT FROM AUTHOR]

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 rates and earlier postoperative visual rehabilitation in small incision cataract surgery. [ABSTRACT FROM AUTHOR]